PUBLIC HEALTH management corporation
TRI-COUNTY AREA COMMUNITY HEALTH NEEDS ASSESSMENT
PREPARED FOR: POTTSTOWN AREA HEALTH & WELLNESS FOUNDATION
PREPARED BY: PUBLIC HEALTH MANAGEMENT CORPORATION 260 SOUTH BROAD STREET, 18TH FLOOR PHILADELPHIA, PA 19102
NOVEMBER 2013 PUBLIC HEALTH management corporation
TABLE OF CONTENTS
I. EXECUTIVE SUMMARY ...... I
II. INTRODUCTION ...... 1 PURPOSE...... 1
III. NEEDS ASSESSMENT PROCESS AND METHODS ...... 2 DATA ACQUISITION AND ANALYSIS ...... 2 COMMUNITY HEALTH NEEDS ASSESSMENT DATA SOURCES AND DATES ...... 2
IV. COMMUNITY OVERVIEW AND DEMOGRAPHICS ...... 6 COMMUNITY OVERVIEW ...... 6 COMMUNITY DEMOGRAPHICS ...... 8 DEMOGRAPHIC CHARACTERISTICS ...... 8 SOCIOECONOMIC CHARACTERISTICS ...... 14
V. FINDINGS ...... 18 HEALTH STATUS OF THE COMMUNITY ...... 18 HEALTH STATUS ...... 24 ACCESS AND BARRIERS TO CARE ...... 32 HEALTH BEHAVIORS ...... 41 HEALTH SCREENINGS...... 58 EXISTING RESOURCES ...... 62
VI. COMMUNITY HEALTH AND WELLNESS NEEDS ...... 67
APPENDICES
APPENDIX A:LIST OF KEY INFORMANT INTERVIEWS APPENDIX B:U.S. CENSUS TABLES APPENDIX C: VITAL STATISTICS TABLES APPENDIX D:HOUSEHOLD HEALTH SURVEY TABLES APPENDIX E:RESOURCE MAPS AND LIST APPENDIX F: STATISTICAL SIGNIFICANCE TESTING RESULTS
PUBLIC HEALTH management corporation
TRI-COUNTY AREA COMMUNITY HEALTH NEEDS ASSESSMENT
I. EXECUTIVE SUMMARY
PURPOSE
This report summarizes the results of an assessment of the health and wellness of residents of the Tri- County Area served by Pottstown Area Health & Wellness Foundation (PAHWF) conducted in 2013.The PAHWF enhances the health and wellness of area residents, providing education, funding, and programs that motivate people to adopt healthy lifestyles. It serves the residents of the area bounded by a ten‐mile radius centered in Pottstown Borough, including seven sub-areascontiguous with seven school districts that are geographic sub-areas of the Tri-County Area. They are: Pottstown Borough, Pottsgrove, Daniel Boone, Owen J. Roberts, Spring-Ford, Perkiomen Valley, and Boyertown Areas.
This needs assessment was conducted by Public Health Management Corporation (PHMC), a private non- profit public health institute that was founded in 1972 to address problems in the organization and delivery of health and social services.
DATA SOURCES
Quantitative Data Quantitative information for this needs assessment was obtained from the following sources for the most recent years available: U.S. Census of Population and Housing; Claritas, Inc. Pop-Facts; Pennsylvania Department of Health; PHMC Southeastern Pennsylvania Household Health Survey; and PHMC Tri-County Area Household Health Survey.
The 2012 SoutheasternPennsylvania Household Health Survey was conducted with 10,018 households in Southeastern Pennsylvania. The information in this report is based on a total of 1,507 interviewsthat were conducted with adults residing in the Tri-County Area, including adults interviewed in the 2012 Household Health Survey and a 2013 re-contact survey of the Tri-County Area.Comparisons were also made with information from 596adults in the PAHWF’s service area who were interviewed for the 2008 Household Health Survey.
Focus Groups and Informational Interviews Members of the PAHWFcommunity were included in this needs assessment through four focus discussion groups of residents and informational interviews with 17 health and wellness service providers. There were four focus groups; a total of40 Tri-County Area residents participated. Focus groups consisted of Youths (14-18), Young Adults (18-25), Underserved Adults (18+), and Parents (18+). Informational interviews were conducted with 17 local providers with expert knowledge of the health and wellness of Tri-County Area residents.
Resources Information on existing health and wellness resources in the Tri-County Area was collected by searching websites for health care, recreational, and nutritional resources and public schools in the Tri-County Area and adjacent Phoenixville Borough.
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The unmet health and wellness needs for the Tri-County Area were identified and prioritized by comparing the health status, access to care, health behaviors, and utilization of services for residents of the Tri- County Area to results for the surrounding counties, the state, and the Healthy People 2020 goals for the nation. Input from focus groups and key informant interviews were also used to further identify and prioritize unmet needs.
COMMUNITY HEALTH AND WELLNESS
Overall, the health status and access to care of Tri-County Area adults and children compares favorably with health indicators for the surrounding Montgomery, Chester, and Berks Counties, the Commonwealth, and the U. S. Surgeon General’s Healthy People 2020 goals for the nation. However, the health of Pottstown Borough adults and children is substantially worse than the health of residents of the Tri-County Area as a whole. Tri-County Area adults and children who are poor or uninsured also experience poorer health and access to care.
Health Status In the Tri-County Area, the overwhelming majority (86.0%) of adults rate their health as excellent, very good, or good.The overwhelming majority of children in the Tri-County Area are also in excellent, very good, or good health (97.7%). Fair or poor health status among adults is nearly three times as common in Pottstown Borough (20.4%) as in the Perkiomen Valley Area (7.2%), where adults are least likely to be in fair or poor health. Pottstown Borough children (5.4%) are also most likely to be in fair or poor health compared with children in the Tri-County Area overall (2.3%). In addition,across the Tri-County Area, adults without health insurance (21.9%) are much more likely to describe their health as fair or poor than are insured adults (13.4%). Adults in the Tri-County Area living below 200% of the Federal Poverty Level are nearly four times as likely to be in fair or poor health as are those living above 200% of the Federal Poverty Level (34.2% compared with 8.8%, respectively).
The overall age-adjusted death rate in the Tri-County Area (720.9 deaths per 100,000 population) is higher than the Berks (712.9), Chester (645.3), and Montgomery (671.9) County mortality rates, but lower than the state rate (763.6). Pottstown Borough (1,075.5 per 100,000 persons) has the highest overall age-adjusted mortality rate in the Tri-County Area, and the highest age-adjusted mortality rates from all cancers (231.1), heart disease (144.4), motor vehicle accidents (99.4), lung cancer (65.5), and stroke (66.8).
There are two key areas of unmet health and wellness needs in the Tri-County Area that are related to overall health status: overweight/obesity and poor access to care.
Overweight and Obesity Nearly two-thirds of adults in the Tri-County Area (64.5%, or about 113,800 adults) are overweight or obese, which is consistent across different insurance and poverty status subgroups and fairly comparable with neighboring counties.
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o Pottstown Borough(26.5%)has the highest rate of child obesity among the seven sub- areas, and the Pottsgrove Area has the highest rate of adult obesity (37.6%). About one-third of children in the Tri-County Area (34.5%) are considered overweight or obese based on their Body Mass Index percentile. One-half of children in poverty are overweight or obese.
Two key health behaviors, healthy eating and physical activity, are related to overweight and obesity in the Tri-County Area.
Healthy Eating In the Tri-County Area, approximately seven in ten adults (69.8%) do not meet the USDA’s MyPlate food guidelines of four to five servings of fruits and vegetables a day. Adults in Pottstown Borough (80.6%) are least likely to consume four or more servings of fruits and vegetables a day compared with the six other sub-areas in the Tri-County Area. Additionally, the majority of children (68.0% or 31,300 children) in the Tri-County Area do not meet this recommended goal.
According to Key Informants and focus group participants, several factors related to unhealthy eating habits in the Tri-County Area include: Lack ofknowledge about healthy foods, including availability and cost. Lack of time, limited healthy cooking skills, and motivation to prepare and eat healthy meals. Lack of access to fresh produce at farmer’s markets and grocery stores with a wide selection due to transportation problems.
Physical Activity More than two in five Tri-County Area adults (43.0%) exercise less than three times per week. o Adults in the Daniel Boone Area (50.0%) are less likely to exercise three times a week than adults in the other six sub-areas. Nearlyone in eight children (12.2%) between the ages of 0-17 in the Tri-County Area exercises less than threetimes a week. o Children in the Pottsgrove Area (15.8%) are more likely to exercise less than three times a week than children in the other sub-areas. Nearly one-third of children in the Tri-County Area watch more than two hours of television per day; an additional 17.8% of children in the Tri-County Area use the computer for more than two hours per day. o Children in the Pottsgrove Area (54.2%) are more likely to watch television for more than two hours a day than children in the other sub-areas. Approximately 106,400 adult residents (59.8%) do not use public recreation facilities in the Tri- County Area. o Three-quarters of adults in the Daniel Boone Area (77.7%), and two-thirds of adults in the Boyertown Area (67.6%), do not use recreation facilities in the Tri-County Area; this is the highest percentage in the Tri-County Area. o Poor adults (74.2%) are more likely not to utilize these recreation facilities. o Cost, transportation, motivation, and time are all barriers to exercise for residents. o Local parks and playgrounds are abundant and well maintained, but transportation is an issue for low-income residents in particular.
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o The lack of sidewalks in the areas outside Pottstown Borough is a safety issue that prevents children and adults from walking or running for exercise in their neighborhood.
Access to Health Care Nine in ten residents of the Tri-County Area (90.2%) have a regular source of care. However, many adults in the Tri-County Area have unmet physical and behavioral health needs. Lack of health insurance coverage, underinsurance, and transportation problems are common barriers to care. The percentage of adults in the Tri-County Area with a regular source of care (90.2%) is higher than the Healthy People 2020 goal of 83.9%. o However, adults in Pottstown Borough (17.0%) are almost twice as likely to lack a regular source of care as adults in the Tri-County Area as a whole (9.7%). The overwhelming majority of children (96.9%) in the Tri-County Area have a regular source of care. o Children in Pottstown Borough (10.9%) are more than three times as likely to lack a regular source of care as children in the area as a whole (3.1%). This represents 500 children in Pottstown Borough.
The overwhelming majority of adults ages 18-64 in the Tri-County Area (92.2%) have health insurance coverage. In the Tri-County Area, 7.8% of adults aged 18-64 are uninsured, representing 11,300 uninsured adults. o Adults aged 18-64 in Pottstown Borough (14.4%; representing 2,000 adults) are almost twice as likely to lack health insurance coverage as adults in the area overall (7.6%). One in seven (14.1%) adults in the Tri-County Area does not have prescription drug coverage; this represents 24,800 adults.
With or without health insurance, 25,300 adults in the Tri-County Area are unable to get needed health care due to the cost of that care (14.2%). In addition, about 27,200 adults in the Tri-County Area did not fill a prescription due to cost in the past year. About 6,800 adults (3.8%) in the Tri-County Area did not seek care in the past year due to transportation problems. o Adults in Pottstown Borough are more likely to lack prescription drug coverage (20.4%), to forego filling a prescription due to cost (21.9%), or not seek care due to transportation problems (7.0%) than adults in the other sub-areas.
Uninsured adults with mental health conditions may not be accessing services.Approximately 29,400 adults across the Tri-County Area (16.5%) have been diagnosed with a mental health condition; this is comparable with, or just slightly higher than, the percentage in neighboring counties. Pottsgrove Area adults (22.4%) are more likely to have a serious mental illness than adults in the other sub-areas, including Pottstown Borough (18.0%). o However, mentally ill adults in Pottstown Borough (48.5%; representing 1,500 adults) are less likely to report receiving treatment for their condition than adults in the other sub- areas. Adults without health insurance are twice as likely to have a mental health diagnosis as those with health insurance (31.9% as compared with 15.3%). Among those with mental health diagnoses, insured adults are more likely to be receiving
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treatment (64.0% as compared with 46.0%) than the uninsured. Across the population in the Tri-County Area, however, nearly one in ten adults (9.4%) have sought professional help for a mental or emotional condition in the past year, and uninsured adults are actually more likely than insured adults to have done so (19.5% as compared with 8.7%).
In summary, the overall health and access to care of Tri-County adults and children is excellent. However, Pottstown Borough adults and children are much more likely to be in poor health and experience economic and cultural barriers to care than residents of the other geographic sub-areas.
Many adults and children in Pottstown Borough and in the Tri-County Area as a whole are overweight or obese, and many lack sufficient physical activity and good nutritional habits to maintain a healthy body weight.
In addition, accessing physical and mental health care may be problematic for uninsured and low-income residents, and residents of areas with lower income levels, such as Pottstown Borough and the Daniel Boone and Boyertown Areas.
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II. INTRODUCTION
PURPOSE
This report summarizes the results of an assessment of the health and wellness of residents of the area served by the Pottstown Area Health & Wellness Foundation (PAHWF).The PAHWF enhances the health and wellness of area residents, providing education, funding, and programs that motivate people to adopt healthy lifestyles. It serves the residents of Pottstown Borough and those within a 10-mile radius of the Borough by funding program grants to non-profit organizations that provide services within the designated Tri-County Area. The PAHWF’s long-term goals include:
1. Funding programs and solutions for long-term improvement in healthy behaviors. Promoting healthy living through nutrition, activities, and programs in public and private schools to reduce obesity and encourage healthy living. Improving parks, programming and the built environment to increase access and physical activity. Creating and promoting social networks involving healthy living. 2. Funding programs for physical health and emotional well-being. 3. Funding learning opportunities and strategic planning to strengthen non-profits.
The purpose of this needs assessment is to identify and prioritize health and wellness needs in the Tri- County Area so that the PAHWF can develop strategies for funding that further its mission and goals, to provide a benchmark against which to measure the impact of the PAHWF’s programs on residents, and to assist the community in planning for the future.
This needs assessment was conducted by Public Health Management Corporation (PHMC), a private non- profit public health institute that was founded in 1972 to address problems in the organization and delivery of health and social services. PHMC creates and sustains healthier communities and envisions a healthy community for all. PHMC uses best practices to improve community health through direct service, partnership, innovation, policy, research, technical assistance, and a prepared workforce.
PHMC’s Center for Data Innovation was uniquely qualified to provide this comprehensive needs assessment of the Tri-County Area. PHMC has many years of experience collaborating withfoundations, community-based organizations, public and private health care providers, and can facilitate the participation of these diverse groups. PHMC staff are public health experts who have conducted many community health needs assessments over the past twenty years for hospitals, health departments, foundations, and other non-profits. Most recently, in 2012 PHMC completed needs assessments for 28 hospitals in Southeastern Pennsylvania to satisfy the requirements of the Affordable Care Act.
This report includes III. Needs Assessment Process and Methods; IV.Community Overview and Demographics; V. Findings and Existing Resources; and VI.CommunityHealth and Wellness Needs. Tables, maps, a list of local resources, and a list of Key Informants who participated in the needs assessment are included in the Appendices.
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III. NEEDS ASSESSMENT PROCESS AND METHODS
The steps in this needs assessment process were: defining the community; identifying existing primary and secondary data and data needs; collecting primary and secondary data; analyzing data; and preparing a written narrative report. The data acquisition and analysis are described in more detail below.
DATA ACQUISITION AND ANALYSIS
Both primary and secondary and quantitative and qualitative data were obtained and analyzed for this needs assessment. Obtaining information from multiple sources, known as triangulation, helps provide context for information and allows researchers to identify results which are consistent across more than one data source.
Community Health Needs Assessment Data Sources and Dates
Quantitative information for this needs assessment was obtained from sources listed below for the most recent years available.
Data Source Dates U.S. Census of Population and Housing 2000, 2010 Claritas, Inc. Pop-Facts 2000, 2010, 2013, 2018 Pennsylvania Department of Health 2007-2010 PHMC Southeastern Pennsylvania Household 2012 Health Survey PHMC Tri-County Area Household Health Survey 2008, 2013
Quantitative information from the U.S. Census, Pennsylvania Vital Statistics, and the Southeastern Pennsylvania Household Health Survey was analyzed for the Tri-County Area using the Statistical Program for Social Sciences (SPSS). For Household Health Survey measures, tests of significance were conducted to objectively identify unmet needs. Qualitative information from focus groups and informational interviews was analyzed by identifying and coding themes common to participants, and also themes that were unique. This information was organized into major topic areas related to health status, access to care, unmet needs, and health care priorities.
PHMC Southeastern Pennsylvania and Tri-County Household Health Surveys The Household Health Survey questionnaires examine health status, utilization of, and access to, health care among adults and children in the five county area including Bucks, Chester, Delaware, Montgomery and Philadelphia Counties. The surveys include many questions that have been administered and tested in national and local health surveys, including items from instruments developed by the following organizations: the National Center for Health Statistics (NCHS) for the National Health Interview Survey (NHIS), The Behavioral Risk Factor Surveillance System (BRFSS), The California Women’s Health Survey, The Social Capital Community Benchmark Survey (Kennedy School of Government, Harvard University), and The Survey on Childhood Obesity (Kaiser Family Foundation/San Jose Mercury News).
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The Household Health Surveys were conducted through telephone interviews with persons18 years of age and older. All telephone households within Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties were eligible to be selected for the sample, as were cell phone users. The 2012 Southeastern Pennsylvania Household Health Survey was conducted with 10,018 households in Southeastern Pennsylvania. A total of 2,101 interviews were conducted with adults residing in the Tri-County Area, including 573 adults aged 65 and over and 499 households with a selected child under the age of 18.The 2013 Tri-County Area Household Health Survey included both follow-up calls to participants in the 2012 Survey as well as new interviews to expand the sample in the targeted service area. New interviews were conducted with 1,334 respondents, and 173 re-contact surveys were conducted with Tri-County Area residents who had participated in the 2012 Southeastern Pennsylvania Household Health Survey. Information from 596 residents of the Berks County portions of the PAHWF’s service area who responded to PHMC’s 2008 Household Health Survey was also included. The 2012 and 2013 surveys were administered for PHMC by Social Science Research Solutions, Inc. (SSRS), a research firm in Media, Pennsylvania. The 2012 survey was fielded between May and September 2012, and the 2013 survey was fielded in June and July 2013.All interviews were administered by telephone. Most households were contacted on home phones (“landlines”) using a computerized Random Digit Dialing (RDD) methodology so that households with unpublished numbers and residents who had recently moved would be included in the sample.A total of 305 cell phone interviews and 1,334 landline interviews were conducted with adults in the Tri-County Area in the 2013 survey. Cell phone respondents received the same survey questionnaire as landline respondents.
The sample for the 2013 survey was drawn from all telephone households in the Daniel Boone, Owen J. Roberts, Perkiomen Valley, Pottsgrove, Boyertown and Spring-Ford Areas and Pottstown Borough. The landline sample was stratified to ensure that at least 150 interviews were completed within each area.
Number of 2013 Tri-County AreaHousehold Health Survey Interviews by Area Area Completed Interviews Boyertown 241 Daniel Boone 206 Owen J. Roberts 228 Perkiomen Valley 162 Pottsgrove 159 Pottstown Borough 283 Spring-Ford 228 Total 1,507
Within each selected household, the Last Birthday Method was used to select the adult respondent for the interview (with the exception of the cell phone sample). In households with more than one eligible adult, the adult who last had a birthday was selected as the adult respondent. In households with children, the person under age 18 who most recently had a birthday was selected for the child interview.
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U.S. Census This report includes data on the characteristics of Tri-County Area residents and residents of Berks, Chester, and Montgomery Counties and the Commonwealth for the years 2000, 2010, 2013 and 2018. Data from the 2000 U.S. Census, the 2010 American Community Survey and the Nielsen-Claritas Pop-Facts Database were also used. The Nielsen-Claritas Pop-Facts Database uses an internal methodology to calculate and project socio-demographic and socioeconomic characteristics for non- census years, relying on the U.S. Census, the Current Population Survey, and the American Community Survey.
Vital Statistics The most recent information on births, birth outcomes, deaths, and reportable diseases and conditions for residents of the Tri-County Area and Berks, Chester, and Montgomery Countiesand Pennsylvaniawas obtained from the Pennsylvania Department of Health, Bureau of Health Statistics and Research. Four year (2007-2010) annualized average rates for natality and mortality were calculated by PHMC. Mortality rates were age-adjusted using the Direct Method and the 2000 U.S. standard million population. The most recent (2010) morbidity information was also obtained from the state Department of Health, and rates were calculated by PHMC. Morbidity information, including information on HIV and AIDS cases, is not available at the Zip Code level and, therefore, rates are presented for the counties and state only. The denominators for all 2007-2010 vital statistics rates for the counties and state were interpolated from the 2000 and 2010 U.S. Census. The number of women ages 15-44 and the number of adolescents ages 10- 17 were also interpolated from the 2000 and 2010 U.S. Census.
Members of the PAHWFcommunity were included in this needs assessment through focus discussion groups of residents and informational interviews with health and wellness service providers. The process for including these individuals in the focus groups and informational interviews is described below.
Focus Groups There were four focus groups of Tri-County Area residents conducted in June and July, 2013 in a central location in the Borough of Pottstown. A total of 40 youth and adults participated in the Youth (14-18), Young Adult (18-25), Underserved Adult (18+), and Parent (18+) Groups. Focus groups were used to collect in-depth information on physical activity and nutrition from these groups of Tri-County Area residents because they are most likely to benefit from this type of programming. Participants were recruited by PHMC staff from the entire Tri-County Area with assistance from the area schools, YMCA, and social service agencies. All adult participants provided signed consent to participate. Participants under the age of 18 provided signed consent forms from a parent or guardian and a signed assent forms. Adult participants were compensated $40 each for their time and transportation costs, and youth age 17 and under were compensated $25. Focus groups lasted approximately 90 minutes and were guided by four different sets of questions on physical activity and nutrition. Specific topic areas included: perceptions of good health and good nutrition; attitudes toward physical activity and good nutrition; perceptions of their own physical activity and nutrition, and that of the residents of the Tri-County Area as a whole; preferred physical activities; and barriers to physical activity and good nutrition. All focus groups were audiotaped. Dinner was provided to participants. See the table below for the breakdown of focus group participants.
Focus Group Number of Participants
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Youth 14-18 9 Young adults 18-25 12 Underserved adults 12 Parents 7
Key Informant Interviews Informational interviews were conducted with seventeen local providers with expert knowledge of the health and wellness of Tri-County Area residents. These Key Informants were identified and recruited by PAHWF staff working in collaboration with PHMC. The names, titles, and organizational affiliations of the Key Informants are listed in Appendix A. Key Informants had direct knowledge of physical and behavioral health and nutrition behaviors and resources in the different communities of the Tri-County Area.
The interviews were conducted in May, 2013 by telephone and lasted approximately 45 minutes. The interviews were guided by questions developed by PHMC in collaboration with the PAHWF staff. Interview topics included perceptions of the health and wellness of residents of the Tri-County Area and its communities, identification of exemplary programs, and suggestions for future programming.
Resources Information on existing health and wellness resources in the Tri-County Area was collected by searching websites for health care, recreational, and nutritional resources and public schools in the Tri-County Area and adjacent Phoenixville Borough. A list of these resources and maps of health care, recreational, and nutritional assets and the public schools are included in Appendix E. A narrative description of these resources is provided in V. Findings, Existing Resources.1
1Private physical and behavioral health practitioners and facilities were not included in the list due to the absence of reliable information.
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IV. COMMUNITY OVERVIEW AND DEMOGRAPHICS
COMMUNITY OVERVIEW
The “Tri-County Area”referred to in this report is the area bounded by a ten‐mile radius centered in Pottstown Borough, including seven sub-areascontiguous with seven school districts in the Tri-County Area.Theseseven sub-areas are located in Berks, Chester, and Montgomery Counties. They are: the Pottsgrove, Daniel Boone, Owen J. Roberts, Spring-Ford, Perkiomen Valley, and Boyertown Areas and Pottstown Borough,as shown in the map on the following page.The Tri-County Area also includes the 28 Zip Codes shown in the table below.
Tri-County Area Zip Codes 18074 19343 19421 19425 19426 19435 19442
19457 19460 19464 19465 19468 19470 19472
19473 19475 19492 19503 19504 19505 19508
19512 19518 19520 19525 19542 19545 19548
For the purposes of this report, the findings were analyzed by different socioeconomic and demographic population subgroups as well as by geographic sub-area. There is a tremendous amount of preventive health and wellness work being done at the school district level, and it is a relevant way to divide the area conceptually.However, it is important to note that when sub‐areas are referred to, they are solely geographic designations and are not referencing any individual school districts.
Pottstown Borough is located in Montgomery County and was established on land originally deeded to William Penn. It is on the Schuylkill River, 32 miles west of Philadelphia.Pottstown was incorporated as a borough in 1815.Originally, Pottstown was the center of a productive farming and dairying region, but iron and steel manufacturing was very extensive. Pottstown enjoyed prosperity until the 1980’s, when many of the manufacturing businesses closed. However, today Pottstown is revitalizing itself with new technological industries, the construction of a new Borough Hall, and a new branch of the Montgomery Community College. In the past few years, a trail and park system along the scenic Schuylkill River has been added.2
The urban Borough of Pottstown is immediately adjacent to the Pottsgrove Area in Montgomery County and Owen J. Roberts Area in Chester County. These areas, and the other four areas in the Tri-County Area, are suburban, rural, and semi-rural. Many of these areas have grown with an influx of commuters to Reading, Philadelphia, and other nearby urban areas.
2http://downtownpottstown.org/history/ Accessed September 30, 2013.
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Tri-County Area Map
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COMMUNITY DEMOGRAPHICS
The demographic and socioeconomic characteristics of a population strongly affect access to care and health status because they include some of the key social determinants of health.This section of the report includes a description of the socioeconomicand demographic characteristics of the residents of the Tri- County Area, and recent and future population trends that can have an impact on access to care and demand for health services. Information on Tri-County Area residents is compared with the characteristics of county and Pennsylvania residents in order to provide context.
Demographic Characteristics
Population size and future trends impact the number of persons using and needing services in an area. Demographic characteristics, such as age, gender, race/ethnicity, and language, can affect the prevalence of specific diseases and conditions and barriers to care that are related to educational attainment, economic status, race, ethnicity, culture, and language.
Population Size Slightly more than 233,000 people live in the seven sub-areas in the Tri-County Area(See Appendix B for U.S. Census Tables).
The Spring-Ford Area (49,100) has the largest population of the seven sub-areas, followed by the Boyertown and Perkiomen Valley Areas (46,800 and 38,400, respectively). The Owen J. Roberts (33,700), Daniel Boone (21,500), and Pottsgrove Areas (21,600), and Pottstown Borough (22,400) have smaller populations (Figure 1).
Figure 1. Population of Tri-County Area, 2013
60,000
50,000 49,096 40,000 46,768 38,433 30,000 33,682
20,000 22,444 21,566 21,452
10,000 NumberofPersons 0 Pottstown Pottsgrove Daniel Owen J. Spring-Ford Perkiomen Boyertown Borough Area Boone Area Roberts Area Valley Area Area Area Source: Nielsen-Claritas Pop-Facts Database, 2013
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The population of the Tri-County Area increased to 233,400residents in 2013 from 193,500residents in 2000. By 2018, the Tri-County Area population is expected to have increased 19.4% since 2000, to 240,000. The population will continue to increase in the next five years. Most of the increase will occur in the Spring-Ford and Owen J. Roberts Areas, while the other sub-area populations will remain relatively stable. The Pottstown Borough population will have increased by only 2.8% (Figure 2). The population of the Spring-Ford and Owen J. Roberts Areas is expected toincrease 29.4% and 23.1%, respectively, between 2000 and 2018.
Figure 2. Percentage Change in Tri-County Area Population by Sub-Area, 2000-2018 35 30 29.4 25 20 23.1
Percent 19.4 20.2 20.4 15 15.1 10 13.5 5 2.8 0 Tri-County Pottstown Pottsgrove Daniel Owen J. Spring-Ford Perkiomen Boyertown Area Borough Area Boone Area Roberts Area Valley Area Area Area Source: Nielsen-Claritas Pop-Facts Database and 2000 U.S. Census
Age In the Tri-County Area,nearly one-quarter of residents (24.9%) are between the ages of 0-17, one-third (33.3%) are 18-44, more than one-quarter are 45-64 (28.8%), and 13.0% are 65 or older (Figure 3). This represents over 58,000 children (0-17) and 78,000 adults aged 18-44 in the Tri-County Area. The age distribution of the population of the Tri-County Area is similar to that of Berks, Chester, and Montgomery Counties. In each of these areas, the largest percentage of residents is aged 18- 44, followed by the percentage of residents aged 45-64, 0-17, and 65+ (Figure 3).
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Figure 3. Age Distribution of Population of Tri-County Area and Adjacent Counties, 2013 40 35 30 33.3 34.0 32.9 32.6 25 28.8 27.4 29.0 28.8 24.9 20 23.3 24.3 22.7
Percent 15 15.3 15.9 10 13.0 13.8 5 0 Tri-County Area Berks County Chester County Montgomery County 0-17 18-44 45-64 65+
Source: Nielsen-Claritas Pop-Facts Dababase and 2010 U.S. Census
Approximately one-quarter of residents of the individual sub-areas are age 17 and younger (Figure 4). About one-third of residents in each sub-area are age 18-44. The Perkiomen Valley Area (37.8%) has the highest percentage of adults aged 18-44, and the Owen J. Roberts Area (29.4%) has the lowest.
Figure 4. Percentage of Residents Ages 0-17 and 18-44 in Tri-County Area by Sub-Area, 2013 40
35 36.8 37.8 33.8 30 33.3 33.6 32.3 30.3 25 29.4 26.5 26.5 24.9 25.1 20 24.1 24.6 24.4 23.4
Percent 15 10 5 0 Tri-County Pottstown Pottsgrove Daniel Boone Owen J. Spring-Ford Perkiomen Boyertown Area Borough Area Area Roberts Area Area Valley Area Area 0-17 18-44 Source: Nielsen-Claritas Pop-Facts Database and 2000 U.S. Census
The number of children (0-17) and adults aged 18-44 in the Tri-County Area is expected to have increased 14.5% between 2000 and 2018, and also to have increased in most sub-areas. By 2018, the percentage of children aged 0-17 in the Perkiomen Valley and Spring-Ford Areas is expected to increase 21.0% and 27.9%, respectively, from 2000, and by 17.8% in the Owen J. Roberts Area.
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The percentage of children aged 0-17 in Pottstown Borough and the Pottsgrove Area will increase less than one percent between 2000 and 2018(0.1% and 0.6%. respectively), and will increase only four percent in the Boyertown Area (3.5%) (Figure 5).
Figure 5. Percentage Change in Tri-County Area Population Ages 0-17 by Sub-Area, 2000-2018 30
25 27.9
20 21.0 15 17.8 15.7 14.5
Percent 10
5 0.1 0.6 3.5 0 Tri-County Pottstown Pottsgrove Daniel Boone Owen J. Spring-Ford Perkiomen Boyertown Area Borough Area Area Roberts Area Area Valley Area Area Source: Nielsen-Claritas Pop-Facts Database and 2000 U.S. Census
The percentage of older adults in the Tri-County Area (13.0%) is the same as in the U.S. as a whole (13.0%). The percentages of older adults in Berks (15.3%) and Montgomery (15.9%) Counties are higher than the Tri-County Areaandnational averages. The percentage of older adults will increase slightly in the Tri-County Area, from 13.0% in 2013 to 14.6% in 2018, as the “baby boomers” continue to age (Figure 6).
Figure 6. Percentage of Adults 65+ in the Tri-County Area and Adjacent Counties, 2000-2018 20 18 17.6 16 16.9 15.8 15.9 14 15.3 15.1 14.6 15 14.5 14.9 13.8 12 13.0 12.8 12.2 10 11.6 11.7
Percent 8 6 4 2 0 Tri-County Area Berks County Chester County Montgomery County
2000 2010 2013 2018 Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census 11 The Center for Data Innovation PUBLIC HEALTH management corporation
Gender Consistent with national trends, one-half of individuals in the Tri-County Area are male, and one-half are female. The gender breakdown within each sub-area is similar, and this is projected to remain static through 2018.
Race/Ethnicity The population of the Tri-County Area is racially and ethnically homogeneous. The overwhelming majority of residents (86.5%) are White, 5.6% are Black, 3.2% are Latino, 2.8% are Asian, and 1.9% identify as another race/ethnicity. The racial/ethnic composition of the Tri-County Area and Berks, Chester, and Montgomery Counties is similar; the majority of residents are White. However, Berks County has the largest percentage of Latino residents (18.0%), and Montgomery County has the largest proportion of Asians (7.0%) among the adjacent counties (Figure 7).
Figure 7. Race and Ethnicity of Tri-County Area Residents and Adjacent Counties, 2013 100 90 80 86.5 80.9 70 75.0 77.5 60 50
Percent 40 30 18.0 20 7.2 8.7 7.0 10 5.6 4.7 3.2 4.2 2.8 5.8 6.1 4.8 0 Tri-County Area Berks County Chester County Montgomery County White Black Asian/Other Latino
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census
The race and ethnicity of residents varies considerably among the Tri-County Areas. For example, Pottstown Borough has the lowest percentage of White residents (66.7%) and highest percentage of Black (19.3%) and Latino residents (8.8%) compared withall of the other areas(Figure 8). In contrast to Pottstown Borough, the Boyertown Area is 94.9% White, with 0.9% of residents identifying as Asian, and 4.3% as another race or ethnicity (Figure 8).
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Figure 8. Race/Ethnicity of Tri-County Area Residents by Sub-Area, 2013
1.7 2.3 Boyertown Area 1.1 94.9 3.9 5.9 Perkiomen Valley Area 7.6 82.6 2.6 7.5 Spring-Ford Area 3.8 86.1 2.2 3.2 Owen J. Roberts Area 2.7 91.9 2.7 3.1 Daniel Boone Area 2.9 91.3 3.2 4.4 Pottsgrove Area 9 83.4 8.8 5.2 Pottstown Borough 19.3 66.7 3.2 4.7 Tri-County Area 5.6 86.5 0 20 40 60 80 100 Percent
Latino Asian/Other Black White Source: Nielsen-Claritas Pop-Facts Database, 2013
The percentage of non-White individuals in the Tri-County Area is projected to continue to increase from 8.7% in 2000 and 13.5% in 2013 to 15.1% in 2018. Conversely, the percentage of White residents in the Tri-County Area will continue to decrease from 91.3% in 2000 and 86.5% in 2013 to 85.0% in 2018.
Language Spoken at Home Nine in ten Tri-County Area residents (93.7%) speak English at home, 2.1% speak Spanish, 1.1% speaks an Asian language, 0.3% speaks another non-European language, and 2.9% speak another European language. Pottstown Borough (4.4%) has the highest percentage of residents who speak Spanish at home among the seven sub-areas, and the Pottsgrove Area has the lowest (1.0%). The Spring-Ford Area (2.8%) has the highest percentage of residents who speak an Asian language at home, and Pottstown Borough (0.2%) has the lowest. The percentage of residents who speak Spanish or an Asian language at home is projected to remain the same for the next five years.
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Socioeconomic Characteristics
Socioeconomic characteristics such as educational attainment, employment, and income all have an impact on health status and access to care. High levels of educational attainment are related to health literacy, healthier behaviors, and improved health status. Employment and income affect insurance status and the ability to pay for out of pocket for health care expenses. The Tri-County Area has a higher level of educational attainment, employment, and income than Pennsylvania as a whole, and, as a result, most residents are in good health and have access to care. However, within the Tri-County Area there are pockets of poverty, primarily in Pottstown Borough, where residents face additional barriers to good health.Income and level of educational attainment are lower in Pottstown Borough than in the other six sub-areas in the Tri-County Area.
Education Adults in the Tri-County Area have a high level of educational attainment compared with adults statewide.However, within the Tri-County Area, Pottstown Borough (17.7%) has the lowest percentage of adults with a college degree or more(Figure 9).
Figure 9. Percentage of Tri-County Area Adults 25+ with a College Degree or More, 2013 50
45 44.2 40 42.1 42.3 35 34.2 30
25 27.4 26.8 26.4 Percent 20
15 17.7 10
5
0 Tri-County Pottstown Pottsgrove Daniel Boone Owen J. Spring-Ford Perkiomen Boyertown Area Borough Area Area Roberts Area Area Valley Area Area Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census
Only one in twelve adults in the Tri-County Area aged 25 and over (8.5%) have less than a high school degree, nearly six in ten (57.4%) are high school graduates, and more than one-third (34.2%) have a college degree or more. In comparison with the Tri-County Area, 11.8% of adults aged 25 and over in the state have less than a high school degree, 61.3% are high school graduates, and 26.9% have a college degree or more. The percentage of college graduates in the Tri-County Area increased between 2000 (25.6%) and 2013 (34.2%), but it is not expected to increase in the next five years (34.3%).
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The Tri-County Area (34.2%) has a lower percentage of adults with a college degree or more compared with Chester (49.2%) and Montgomery (44.7%) Counties. The Tri-County Area does, however, have a higher percentage of adults with a college degree or more than Berks County (22.5%)(Figure 10).
Figure 10. Percentage of Tri-County Area Adults 25+ with a College Degree or More by County, 2013 60
50 49.2 40 44.7
30 34.2 Percent 20 22.5 10
0 Tri-County Area Berks County Chester County Montgomery County Source: Nielsen-Claritas Pop-Facts Database, 2013
Employment While the percentage of unemployed adults in the Tri-County Area (7.2%) is higher than in Chester and Montgomery Counties (3.9% in each), it is lower than that of Pennsylvania as a whole (9.6%).Within the Tri-County Area, adults in Pottstown Borough (10.1%) have the highest unemployment rate. The unemployment rate is projected to remain the same in the next five years.
One in eight Tri-County Area workers (12.1%) commutes 60 minutes or more to work. In comparison with the Tri-County Area, 8.4% of Pennsylvania workers have long commutes. Workers in the Pottsgrove Area (16.2%) are most likely to report a long commute, and workers in Pottstown Borough (9.3%) are least likely to commute 60 minutes or more. The percentage of workers in the Tri-County Area with long commutes increased slightly between 2000 (10.2%) and 2013 (12.1%), and is expected to remain the same (12.1%) in 2018.
Poverty Status The Tri-County Area as a whole has a low poverty rate compared with the state overall, although Pottstown Borough has a higher percentage of families with children in poverty.Six percent (5.8%) of Tri-County Area families with children, and 3.9% of all families, are living with incomes below 200% of the Federal Poverty Level compared with the percentages statewide (9.1% and 15.3%, respectively). This represents approximately 1,800 families with children and 2,400 families who are living in poverty in the Tri-County Area, respectively. The percentage of families in the Tri-County Area living in poverty is higher than the percentage for Chester and Montgomery Counties, but lower than for Berks County.
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Within the entire PAHWF service area, Pottstown Borough (13.8%) has the highest percentage of families with children living in poverty. In contrast to Pottstown Borough, only 3.1% of families with children in the Spring-Ford Area are living in poverty (Figure 11).
Figure 11. Percentage of Tri-County Area Families with Children in Poverty* by Sub-Area, 2013 16 14 12 13.8 10 10.1 8
Percent 6 6.2 4 5.8 5.1 4.7 3.9 2 3.1 0 Tri-County Pottstown Pottsgrove Daniel Owen J. Spring-Ford Perkiomen Boyertown Area Borough Area Boone Area Roberts Area Area Valley Area Area Area
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census *Below 100% of Federal Poverty Level
Median Household Income The 2013 median household income in the Tri-County Area is $75,900, an increase from $57,700 in 2000.Median household income is expected to increase to $81,700in the next five years (Figure 12).
Figure 12. Median Annual Household Income of Tri-County Area and Adjacent Counties, 2000-2018 $100 $90 $80 $70 $60 $50
Thousands $40 Tri-County Area $30 Berks County $20 Chester County $10 Montgomery County $0 2000 2010 2013 2018
Pottstown Borough residents have the lowest median annual household income ($44,300) in the Tri-County Area.Within the Tri-County Area, there is a gap of almost $50,000 in median annual
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income among the seven sub-areas. The residents of the Perkiomen Valley Area have the highest median annual income ($93,000). The 2013 median household income in theTri-County Area is comparable with Berks County, but lower than Chester and Montgomery Counties (Figure 13).
Figure 13. Tri-County Area Median Annual Household Income by Sub-Area, 2013 $100,000 $90,000 $92,961 $80,000 $85,327 $84,376 $70,000 $75,911 $60,000 $71,976 $71,656 $69,152 $50,000 $40,000 $44,340 $30,000 $20,000 $10,000 $0 Tri-County Pottstown Pottsgrove Daniel Boone Owen J. Spring-Ford Perkiomen Boyertown Area Borough Area Area Roberts Area Area Valley Area Area
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census
Home Ownership More than three-quarters of Tri-County Area residents (78.5%) own their homes, although residents of Pottstown Borough (55.0%) are least likely among residents of the Tri-County area to own their homes.The percentage of residents of the Tri-County Area who own their home is higher than in Berks (71.6%), Chester (76.1%), and Montgomery (73.0%)Counties, as well as in Pennsylvania as a whole (69.5%). Residents of the Perkiomen Valley Area are most likely (85.1%) to be homeowners.
The next section, V. Findings, summarizes the results of the assessment of the health of Tri-County Area residents.
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V. FINDINGS
HEALTH STATUS OF THE COMMUNITY
The health of a community can be assessed by comparing birth outcomes, self-reported health status and health conditions, communicable disease rates, self-reported health concerns and perceptions, and mortality rates to statewide health indicators and Healthy People 2020 goals for the nation. Gaps between local and national health indicators and Healthy People 2020 goals can be compared to identify and prioritize the unmet health needs of the community.
Overall, the health indicators for birth outcomes, morbidity, and mortality in the Tri-County Area are more positive than for Pennsylvania as a whole. However, birth indicators, morbidity, and mortality for Pottstown Borough are worse than for the other six sub-areas and do not meet the applicable Healthy People 2020 goals for the nation.
Health Status
Birth Outcomes Birth Rate The Birth Rate in an area is a critical factor in assessing the supply of services for pregnant women and infants.
There areapproximately 2,760 births annually to women in the Tri-County Area, which is a slightly higher birth rate than in the surrounding counties(See Appendix C for the Vital Statistics Tables). The birth rate in the Tri-County Area (64.0 per 1,000 women 15-44 years of age) is slightly higher compared with Berks (62.1), Chester (58.1), and Montgomery (60.2) Counties, and Pennsylvania as a whole (57.4). Within the Tri-County Area, Pottstown Borough has the highest birth rate (86.9births per 1,000 women 15-44 years of age) and the Boyertown Area has the lowest (54.5).
Teenage pregnancy has been associated with a number of negative birth outcomes, including prematurity and low birth weight, making it an important outcome to track. The adolescent birth rate in the Tri-County Area is 2.7 births per 1,000 women 10-17 years of age, which is lower than rates in Berks (8.6), Chester (2.8), and Montgomery (2.8) Counties, and Pennsylvania as a whole (6.3).
Low Birth Weight Low birth weight infants (<2,500 grams or 5lbs 8 ounces) are at greater risk for dying within the first year of life compared with infants of normal birth weight. The low birth weight rate in the Tri-County Area(66.5 per 1,000 live births) meets the Healthy People 2020 goal rate of 78.0. The low birth weight rate in the Tri-County Area (66.5) is comparable with Chester County (66.1), butlower than in Berks (79.2) and Montgomery (71.4) Counties, and Pennsylvania (82.7). The Tri-County Area low birth weight rate represents the birth of approximately 180 infants weighing less than 2,500 grams at birth every year (Figure 14).
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Low birth weight rates vary considerably among the seven sub-areas(Figure 15).For instance, the low birth weight rate in the Pottsgrove and Daniel Boone Areas (57.1) is much lower than the rate in the Spring-Ford(74.1) and Boyertown (73.9) Areas and Pottstown Borough (73.2).
Figure 14. Average Annual Rate of Tri-County Area and Adjacent County Infants Born at Low Birth Weight (<2,500 grams), 2007-2010 85
80 79.2 75
70 71.4
Per 1,000 Births 65 66.5 66.1
60
55 Tri-County Area Berks County Chester County Montgomery County Source: Pennsylvania Department of Health, Bureau of Health Statistics and Research. Calculations prepared by PHMC.
Figure 15. Average Annual Rate per 1,000 Live Births of Tri-County Area Infants Born at Low Birthweight (<2,500 grams) by Sub-Area, 2007-2010
Owen J. Roberts Area 57.4
Boyertown Area 73.9
Perkiomen Valley Area 61.0
Spring-Ford Area 74.1
Daniel Boone Area 56.9
Pottsgrove Area 57.1
Pottstown Borough 73.2
Tri-County Area 66.5
0 20 40 60 80
Healthy People 2020 Goal = 78.0 Source: Pennsylvania Department of Health, Bureau of Health Statistics and Research. Calculations prepared by PHMC.
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Infant Mortality Rate Infant mortality is relatively rare in the Tri-County Area: 4.0 infant deaths per 1,000 live births. This represents an average of 11 infant deaths annually. The Tri-County Area’s infant mortality rate (4.0) is lower than rates for Berks (7.7), Chester (4.7), and Montgomery (4.8) Counties, and the Pennsylvania rate (7.1). The Tri-County Area’s infant mortality rate meets the Healthy People 2020 goal rate (6.0).
Mortality Overall mortality rates in the Tri-County Area are relatively low compared with state rates, but higher than the rates for surrounding counties. The leading causes of death are similar to national trends, except for the high rate of motor vehicle deaths, which is the third leading cause of death after cancer and heart disease.
Overall Mortality The overall age-adjusted death rate in the Tri-County Area (720.9 deaths per 100,000 population) is higher than the Berks (712.9), Chester (645.3), and Montgomery (671.9) Countyage-adjusted mortality rates, but lower than the state rate (763.6)(Figure 16). Pottstown Borough (1,075.5 per 100,000 persons) has the highest overall age-adjusted mortality rate in the Tri-County Area, and the highest age-adjusted mortality ratesfor all cancers (231.1), heart disease (144.4), motor vehicle accidents (99.4), lung cancer (65.5), and stroke (66.8). Cancer is the leading cause of death in the Tri-County Area (165.8), Berks (167.7), Chester (167.1), and Montgomery (165.5) Counties, and the state (179.9). The other four leading causes of death in the Tri-County Area are: o Coronary heart disease (114.4); o Motor vehicle accidents (55.3); o Lung cancer (45.3); and o Cerebrovascular disease (44.1). Age-adjusted death rates from all forms of cancer, lung cancer, and heart disease are all comparable in the Tri-County Area to those in Berks, Chester, and Montgomery Counties.
Female breast cancer results in the death of 26 Tri-County Area women each year. The age-adjusted mortality rate from female breast cancer in the Tri-County Area (19.5 deaths per 100,000 females) is lower than theage-adjusted breast cancer mortality rates in Berks (23.1), Chester (21.8), and Montgomery (21.6) Counties, as well as in Pennsylvania as a whole (23.4).
Prostate cancer takes the lives of 15 Tri-County Areamen each year. Again, the age-adjusted prostate cancer mortality rate in the Tri-County Area (17.0) is lower than in Berks (18.1), Chester (20.1), and Montgomery (22.6) Counties, and the state (22.1).
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Figure 16. Top Five Average Annual Age-Adjusted Mortality Rates for Tri-County Area and Adjacent Counties, 2007-2010
PA
Montgomery County
Chester County
Berks County
Tri-County Area
0 50 100 150 200 Rate per 100,000 persons Cerebrovascular Disease Lung Cancer Motor Vehicle Accidents Coronary Heart Disease All Cancers
Sources: PA Department of Health, Bureau of Health Statistics and Research and Nielsen-Claritas Pop-Facts Database
Morbidity3 Rates of reportable diseases in Montgomery County are generally lower than those for the state, but rates of some diseases are higher in Montgomery County than in the other surrounding counties. In particular, rates of pertussis (whooping cough) and chronic Hepatitis B are higher in Montgomery County.
HIV and AIDS The rate of individuals who are living with HIV or AIDS in Montgomery County (4.9cases per 100,000 population) is lower than the rate for Berks County (8.0) and Pennsylvania as a whole (6.5), but is higher than in Chester County (2.4). This represents an average of 116 new cases of HIV or AIDS in Montgomery County annually.
Communicable Diseases The rate of new cases of Lyme disease in Montgomery County (57.1; representing 1,347 new cases reported each year) is lower than the rate in Chester County (158.3 per 100,000 population), but is higher than in Berks County (23.0) and in the state as a whole (35.8).
Pertussis (whooping cough) rates are more than twice as high in Montgomery County (11.9) as in Berks (3.7) or Chester (5.1) Counties.
3Information on the number of Pennsylvania residents who contract communicable and notifiable diseases every year is reported for individual counties and the state, in order to protect the individual’s privacy. Information for Montgomery County, the county in which the Foundation is located, is reported first.
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This represents 280 new pertussis cases annually in Montgomery County. Pertussis can be prevented in children over two months of age and in adults by a series of vaccinations.
Varicella (Chicken Pox) incidence rates are lower in Montgomery County (11.9) than in Berks (16.5) and Chester (15.1) Counties. This represents 280 new cases of varicella every year in Montgomery County, and a comparable number in the other two counties. Chicken Pox can also be prevented in children 12 months and older and in adults by a series of two vaccinations.
The incidence rates of the sexually transmitted infections Chlamydia (183.8) and Gonorrhea (33.9) are lower in Montgomery County than in Berks County (299.3 and 39.9, respectively) but higherthan in Chester County (170.3 and 29.7, respectively).
Montgomery County has a higher rate of chronic Hepatitis B (20.8) than Berks (11.5) and Chester (7.3) Counties.Hepatitis B is spread through contact with body fluids.
Fair or Poor Health Self-reported health status is one of the best indicators of population health. This measure has consistently shown to correlate very strongly with mortality rates. 4 In the Tri-County Area, the overwhelming majority of adults (86.0%) rate their health as excellent, very good, or good (See Appendix D for Household Health Survey Tables). Several Key Informants believe that the physical and mental health problems in the Tri-County Area are similar to health problems of most small towns and cities.
However, about one in seven adults in the Tri-County Area (14.0%) is in fair or poor health, representing 24,800 adults. This percentage is comparable with the statewide average(16.8%),5 and higher than the average for Chester (9.6%) and Montgomery (10.8%) Counties, while lower than the average for Berks County (15.9%). Fair or poor health status among adults is nearly three times as common in Pottstown Borough (20.4%) as in the Perkiomen Valley Area (7.2%), where adults are least likely to be in fair or poor health. Among older adults in the Tri-County Area, more than one in five (21.3%) is in fair or poor health; this percentage represents 6,900 adults 65 years of age and older. Children are typically in good health; this holds true across the Tri-County Area (97.7%). A small percentage is in fair or poor health (2.3%); this represents approximately 1,300 children in fair or poor health. o Pottstown Borough children (5.4%) are more likely to be in fair or poor health compared to children in the Tri-County Area overall (2.3%). Across the Tri-County Area, adults without health insurance (21.9%) are much more likely to describe their health as fair or poor than are insured adults (13.4%). Adults living below 200% of the Federal Poverty Level are nearly four times as likely to be in fair or poor health as are those living at or above 200% of the Federal Poverty Level (34.2% versus 8.8%).
4Idler EL, Benyamini Y. Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies. Journal of Health and Social Behavior.1997; 21-37. 52011 Behavioral Risks of Pennsylvania Adults, PA Department of Health.
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Almost all focus group participants, regardless of age or other demographic factors, felt that being in good physical health requires regular exercise and eatinga healthy diet, and that good health involvesboth mental and physical health.
As stated by one focus group participant:
“Exercise, diet, eat fruits and vegetables. I stay away from other people’s smoke. Staying away from stress. That’s part of it. Health is really a balance of all of those [factors]. You don’t have to be an athlete or anything as long as you are happy with who you are. It is really a balance of all three, emotional, physical, spiritual.” (Young adult group)
Another focus group participant stated:
“Good shape. Exercise, dieting. I think it should be where you get a physical check-up from your doctor and everything is good from your blood work to your heart. Taking all of your medications if you are asthmatic or diabetic, or with high blood pressure.” (Underserved adult group)
Key Informants feel that many Tri-County Area residents struggle to maintain good health in the face of economic challenges, and that the overall mood of the community does not support health and wellness activities long term. The health status of the Tri-County Area may be similar to many of the surrounding communities. However, there are opportunities and resources for Tri-County Area residents to take advantage of to improve their health. Key Informants also appreciate the support the PAHWF provides in the community. Key Informants see a need for increased prevention education and leadership in addressing economic needs to spark the behavioral changes that will improve health in the community.
Specific Health Conditions Across the Tri-County Area, many adults have chronic conditions that require ongoing care. In general, chronic disease prevalence in the Tri-County Area is very similar to chronic disease rates for Berks, Chester, and Montgomery Counties. However, many adults in the Tri-County Area have more than one chronic health condition, which increases their need for ongoing care and requires greater expenditures for health care at the individual and systemic level.
Since diabetes and heart disease, and heart disease and high blood pressure, are related, it is not surprising that 12,000 Tri-County Area adults have both diabetes and high blood pressure, 11,600 have heart disease and high blood pressure, and 4,500 have heart disease and diabetes (Figure 17).
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Figure 17. Number of Tri-County Area Adults with More than One Chronic Health Condition, 2013
14,000 11,600 12,000 12,000 10,000 8,000
6,000 4,500 Number 4,000 2,000 - Heart Disease & HBP Diabetes & HBP Heart Disease & Diabetes
Sources: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
Overweight and obesity are factors in many chronic illnesses. Nearly two-thirds of adults in the Tri- County Area (64.5%, or about 113,800 adults) are overweight or obese, which is consistent across different insurance and poverty status subgroups and fairly comparable with neighboring counties (Figure 18).
Figure 18. Percentage of Overweight and Obese Tri-County Area Adults (18+) by Insurance and Poverty Status 80
70
60
50 30.2 30.3 36.9 28.3 40
24.9 Percent 30
20 35.1 35.2 34.3 30.5 10 23.5
0 Tri-County Area Uninsured Insured Poor Non-Poor Overweight Obese Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poverty = below 200% of Federal Poverty Levels. Obese=BMI>30; Overweight=BMI=25-29.
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About one-third of children in the Tri-County Area (34.5%) are considered overweight or obese based on their Body Mass Index6 percentile (Figure 19). o Pottstown Borough (26.5%) has the highest rate of child obesity among the seven sub- areas, and the Pottsgrove Area has the highest rate of adult obesity (37.6%). The Spring-Ford Area has the lowest rate of adult (21.8%) and child (8.8%) obesity among the seven sub-areas in the Tri-County Area (30.0% and 15.6%, respectively). o Overweight and obesity levels are higher among children in poverty; one-half of children living below 200% of the Federal Poverty Level in the Tri-County Area(50.5%) are overweight or obese, compared with 31.4% of children living at or above 200% of the Federal Poverty Level. o Overweight and obesity levels among children are slightly higher in the Tri-County Area than among children in neighboring counties (29.8% of children in Chester County and 31.7% of children in Montgomery County are classified as overweight or obese).
Figure 19. Percentage of Overweight or Obese Tri-County Area Children (6-17) by Age and Poverty Status 60
50
40 21.8
17.5 30
Percent 15.6 14.4 14.1 20 28.7 23.6 10 18.9 15.1 17.0
0 Tri-County Area 6-11 12-17 Poor Non-Poor
Overweight Obese
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poverty= below 200% of Federal Poverty Level. Obese=BMI>95th percentile, Overweight=BMI=85-95th percentile.
Obese and overweight adults in the Tri-County Area are more likely to have heart disease, diabetes, high blood pressure, and cancer than adults who are at normal weight or underweight (Figure 20). Adults who are obese or overweight (14.6%) are more than three times as likely to have diabetes as non-overweight and obese adults (4.1%).
6 According to information on child obesity based on measurements taken by school nurses in the Tri-County Area school districts, a lower percentage (28.6%) of children are obese or overweight. This may be related to different methods and time periods in which the data were collected.
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Obese and overweight adults (36.8% and 9.5%, respectively) are more than twice as likely to have high blood pressure or to have had cancer as normal and underweight adults (15.6% and 4.8%, respectively).
Figure 20. Percentage of Tri-County Area Adults with Selected Conditions by Weight, 2008 & 2013
40% 36.8% 35% 30% 25% 20% 15.6% 14.6% Percnet 15% 10.4% 9.5% 10% 8.7% 4.1% 4.8% 5% 0% Heart Disease High Blood Pressure Diabetes Cancer Obese/Overweight Normal/Underweight Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013. More specifically, approximately 19,400 adults in the Tri-County Area (10.9%) have been diagnosed with diabetes. Diabetes rates are highest among adults in the Boyertown Area (14.0%) and lowest in the Owen J. Roberts Area (7.6%); nearly one-half the rate in the Boyertown Area. Adults living below 200% of the Federal Poverty Level are more than twice as likely to report a diabetes diagnosis as are those living at or above 200% of the Federal Poverty Level (18.3% and 8.9%, respectively). Five Key Informants feel that Type II diabetes is one of the greatest health concerns in the region, and suggest that many diabetics in the area need education on healthy cooking and other healthy lifestyle choices.
About one in ten Tri-County Area adults (9.7%) have been diagnosed with heart disease, representing 17,300 adults. One-quarter of adults aged 65+ in the Tri-County Area (25.5%) have heart disease. Adults living below 200% of poverty are more than twice as likely to have heart disease as those at or above 200% of poverty (18.1% compared with 7.7%).
Across the Tri-County Area, approximately 13,700 adults (7.7%) have ever been diagnosed with cancer. More than one in five older adults (65+) in the Tri-County Area (21.1%) has had cancer. Slightly more adults in the Daniel Boone (10.6%) and Owen J. Roberts (10.5%) Areas have been diagnosed with cancer than in the Tri-County Area overall (7.7%). Five Key Informants are concerned about the prevalence of cancer in the area. However, mortality rates for cancer in the Tri-County Areaare similar to those for the adjacent counties and
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the entire state.
Approximately 28,300 adults in the Tri-County Area(15.9%) have been diagnosed with asthma. One-quarter of uninsured adults (26.5%) have been diagnosed with asthma. Adult asthma varies across sub-areas in the Tri-County Area, from 10.2% in the Spring-Ford Area to 25.5% in Pottstown Borough.
About 7,400 children ages 0-17 in the Tri-County Area (13.6%) have asthma. Children living below 200% of poverty are more than twice as likely to have asthma as children living at or above 200% of poverty; 28.2% of children in poverty have asthma compared with 10.9% of children at or above poverty. Similar to adults, children in Pottstown Borough are twice as likely to have been diagnosed with asthma as children in the Tri-County Area as a whole (25.6% vs. 13.7%).
Three in ten Tri-County Area adults (29.4% or about 52,400 persons) have been diagnosed with high blood pressure(Figure 21). More than one-third of uninsured Tri-County Area adults (34.9%) have this diagnosis. The percentage of adults with high blood pressure is similar across the seven sub-areas in the Tri- County Area.
Figure 21. Percentage of Tri-County Area Adults (18+) with High Blood Pressure by Insurance and Poverty Status 40
35
30
25
20 36.8
Percent 34.9 15 29.4 29.1 27.7 10
5
0 Tri-County Area Uninsured Insured Poor Non-Poor
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poverty=below 200% of the Federal Poverty Level.
Chronic pain can have many causes. Across the Tri-County Area, about one-quarter of adults (23.4%) have chronic pain, described as pain lasting six months or longer.This represents 42,400 adults. Adults living below 200% of poverty and/or without health insurance are more likely to report chronic pain; four in ten adults in each group (40.0% of uninsured adults and 39.8% of adults below 200% of poverty) have chronic pain.
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Nearly one-quarter of Tri-County Area adults (23.7%) have some form of arthritis. As with many chronic conditions, arthritis is more common among older adults. One-half of adults aged 65+ in the Tri-County Area (49.3%) have arthritis. A greater percentage of adults in the Pottsgrove Area have arthritis than in the other sub-areas. Three in ten adults in the Pottsgrove Area (30.0%) have been diagnosed with arthritis.
Key Informants most frequently cite overweight and obesity in adults (n=15) and in children as the most common health problem in the region. They feel that obesity is often directly related to poor nutrition, and that children are skipping breakfast and eating fast food, even if parents are preparing fresh food at home. Three Key Informants feel that students in higher income areas have better access to healthy, locally produced foods.
Trends in Health Status, 2008-2013 The percentage of adults in fair or poor health in the Tri-County Area in 2013 is one-half the percentage in fair or poor health in 2008 (26.1% versus 13.9%) (Figure 22). The percentage of adults in fair or poor health remained relatively the same in Pottstown Borough between 2008 and 2013, decreased in four of the other sub-areas, and increased in the Spring- Ford and Daniel Boone Areas.
Figure 22. Percentage of Tri-County Area Adults in Fair/Poor Health by Sub-Area, 2008 & 2013 30% 26% 25% 21% 21% 21%20% 20% 18% 19% 16% 14% 14% 14% 15% 13% 13% 10% Percent 9% 10% 7% 5%
0% Tri-County Boyertown Owen J. Perkiomen Pottsgrove Pottstown Spring-Ford Daniel Area Area Roberts Valley Area Area Borough Area Boone Area Area 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
Although the percentage of adults in fair or poor health in the Tri-County Area has decreased slightly since 2008, the percentage of adults with diabetes, obesity and overweight, high blood pressure, and asthma, have all increased during the same time period (Figure 23). The percentage of adults with asthma, diabetes, and high blood pressure increased approximately 3% in the Tri-County Area, and the percentage of adults who are overweight or obese increased about 6%.
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Figure 23. Percentage of Tri-County Area Adults with Selected Conditions, 2008 & 2013 80% 69.6% 70% 63.1% 60%
50%
40%
Percent 29.5% 30% 26.1%
20% 15.9% 15.8% 13.4% 11.6% 8.7% 10.5% 10%
0% Fair/Poor Health Obese/Overwieght Diabetes High Blood Asthma Pressure 2008 2013
Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
For example, the percentage of adults who have been diagnosed with diabetes has increased in six of the seven sub-areas since 2008, particularly in the Boyertown Area (10.7% versus 16.0%), but has decreased by about 5% in Pottstown Borough, from 14.1% to 8.8% (Figure 24).
Figure 24. Percentage of Tri-County Area Adults Diagnosed with Diabetes, 2008 & 2013 16% 14% 14% 14% 13% 12% 12% 11% 11% 10% 9% 10% 9% 9% 9% 9% 8% 8% 7% 6% Percent 6% 6% 4% 2% 0% Tri-County Boyertown Owen J. Perkiomen Pottsgrove Pottstown Spring-Ford Daniel Area Area Roberts Valley Area Area Borough Area Boone Area Area 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
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Similarly, the percentage of adults in the Tri-County Area with high blood pressure has increased in all of the sub-areas except in Pottstown Borough, where it decreased from 32.6% to 29.9%, and the Spring- Ford Area (28.3% versus 27.7%) (Figure 25).
Figure 25. Percentage of Tri-County Area Adults with High Blood Pressure by Sub-Area, 2008 & 2013
35% 33% 31% 32% 29% 30% 29% 30% 30% 30% 28% 28% 26% 27% 25% 24% 25% 19% 20% 17%
15% Percentage 10%
5%
0% Tri-County Boyertown Owen J. Perkiomen Pottsgrove Pottstown Spring-Ford Daniel Area Area Roberts Area Valley Area Area Borough Area Boone Area 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
The percentage of overweight and obese adults has increased slightly since 2008 in four sub-areas, and decreased slightly in the in the Boyertown and Perkiomen Valley Areas (Figure 26).
Figure 26. Percentage of Overweight and Obese Tri-County Area Adults, 2008 & 2013
80% 72%71% 67% 68% 69% 68% 70% 64% 66% 65% 66% 63% 63% 62% 59% 60% 57%58% 50% 40%
Percent 30% 20% 10% 0% Tri-County Boyertown Owen J. Perkiomen Pottsgrove Pottstown Spring-Ford Daniel Area Area Roberts Valley Area Area Area Area Boone Area Area 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
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Mental and Behavioral Health Nearly one-quarter of adults in the Tri-County Area, 24.4%, are under high levels of stress. This was consistent across age groups from 18 to 64; however older adults (65+) are less likely to report high stress (13.3%). While reports of high stress are similar among those below and at or above 200% of the Federal Poverty Level (27.1% and 28.8%), stark contrasts are seen between those with and without health insurance: o Uninsured adults (54.4%) are more than twice as likely to report high stress as the insured (21.0%).
Approximately 29,400 adults across the Tri-County Area (16.5%) have been diagnosed with a mental health condition; this is comparable with,or just slightly higher than,the percentage in neighboring counties (Figure 27). Pottsgrove Area adults (22.4%) are more likely to have a serious mental illness than adults in the other sub-areas, includingPottstown Borough (18.0%). o The percentage of adults with a diagnosed mental health condition ranges from 13.0% in the Daniel Boone Area and 13.4% in the Spring-Ford Area to 22.4% in the Pottsgrove Area. However, mentally ill adults in Pottstown Borough (48.5%; representing 1,500 adults) are least likely to report receiving treatment for their condition compared with adults in the other sub- areas. o Adults in the Daniel Boone Area are more likely to be receiving treatment (76.7%) than those in other sub-areas. Adults without health insurance are twice as likely to have a mental health diagnosis as those with health insurance (31.9% as compared with 15.3%). o Among those with mental health diagnoses, insured adults are more likely to be receiving treatment (64.0% as compared with 46.0%) than the uninsured. Across the population in the Tri-County Area, however, nearly one in ten adults (9.4%) have sought professional help for a mental or emotional condition in the past year, and uninsured adults are actually more likely than insured adults to have done so (19.5% as compared with 8.7%). Many Key Informants feel that serious chronic mental illness in adults (n=10), depression, and stress (n=6) arecommon mental health problems in the Tri-County Area.
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Figure 27. Percentage of Tri-County Area Adults (18+) Diagnosed with a Mental Health Condition by Insurance and Poverty Status 35
30
25
20
15 31.9 Percent 25.3 10 16.5 15.3 14.1 5
0 Tri-County Uninsured Insured Poor Non-Poor Area Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poverty=below 200% of Federal Poverty Level.
Several Key Informants perceive that there are more adults with mental illness living in Pottstown Borough. They feel that this is, in part, attributable to the existence of a mental health treatment program in the Borough, and a corresponding lack of treatment programs in surrounding suburban areas. Opinions about mental illness among children in the region vary. Key Informants report that behavior problems, stress,self-esteem issues, promiscuous behaviors, disorders on the autism spectrum, and suicide are increasing among children in the area.
Approximately 13,100 adults in the Tri-County Area (7.4%) are in recovery from alcohol or other drugs; this percentage is much higher among the uninsured than the insured (25.1% as compared with 6.1%).Key Informants perceive drug, alcohol, and tobacco use and addiction to be issues of concern in the Tri-County Area.
Access and Barriers to Care
The Healthy People 2020 Goals for access to health care include: Increase the percentage of women initiating prenatal care in the first trimester to 77.9%; Increase the proportion of the population with health insurance to 100%; Reduce the proportion of individuals who are unable to obtain or delay in obtaining necessary medical care, dental care or prescription medicines to 9.0% overall (4.2% for medical care, 5.0% for dental care and 2.8% for prescription medications);and Increase the proportion of persons with a usual primary care provider to 83.9%.
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Pre-Natal Care Receiving pre-natal care during the first trimester of pregnancy can help ensure that health concerns are identified and addressed in a timely manner.
More than one in five women in the Tri-County Area (21.5%) receives late or no prenatal care. This represents almost 600 women annually. This percentage compares favorably to Berks (30.7%), Chester (26.6%), and Montgomery (26.7%) Counties, as well as to Pennsylvania as a whole (29.8%) (Figure 28). Nearly eight in ten women in the Tri-County Area (78.5%) receive adequate prenatal care, a percentage meeting the Healthy People 2020 target goal (77.9%). One-third of pregnant women in Pottstown Borough (34.1%) receive late or no prenatal care; this percentage does not meet the Healthy People 2020 goal of 22.1%. Pottstown Borough women are more likely to receive late or no prenatal care than all other sub- areas (Figure 29).
Several Key Informants discussed access to prenatal care in the Tri-County Area. Pottstown Memorial Medical Center provides prenatal and obstetrical care to insured and uninsured women. The addition of a hospital-affiliated obstetrician to the staff of the new High Street branch of Community Health and Dental Care is expected to increase access to services for many low-income women.
Figure 28. Average Annual Percentage of Pottstown Area and Adjacent County Women with Late* or No Prenatal Care, 2007-2010 35 30 30.7 25 26.6 26.7 20 21.5
15 Percent 10 5 0 Tri-County Area Berks County Chester County Montgomery County Sources: Pennsylvania Department of Health, Bureau of Health Statistics and Research. and Nielsen- Claritas Pop-Facts Database Calculations prepared by PHMC. *After the first trimester.
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Figure 29. Average Annual Percentage of Tri-County Area Women Receiving Late* or No Prenatal Care by Sub-Area, 2007-2010
Owen J. Roberts Area 20.5
Boyertown Area 19.7
Perkiomen Valley Area 17.8
Spring-Ford Area 18.2
Daniel Boone Area 19.0
Pottsgrove Area 22.7
Pottstown Borough 34.1
Tri-County Area 21.5
0 10 20 30 40
Healthy People 2020 Goal 22.1% Source: Pennsylvania Department of Health, Bureau of Health Statistics and Research . Calculations prepared by PHMC. *After the first trimester.
Health Insurance Status Having health insurance and a regular place to go when sick are important in ensuring continuity of care over time. The overwhelming majority of adults aged 18-64 in the Tri-County Area(92.2%) have health insurance coverage.
However, a sizable percentage of adults do not have any private or public health insurance; 7.8% of adults aged 18-64 in the service area are uninsured, representing 11,300 uninsured adults.
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Figure 30. Percentage of Tri-County Area Adults (18+) who Did NOT Seek Care Due to Cost by Insurance and Poverty Status
60
50
40
30
Percent 52.3 20
25.7 10 14.2 11.4 11.0 0 Tri-County Area Uninsured Insured Poor Non-Poor
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poor=Below 200% of Federal Poverty Level.
Adults ages 18-64 in Pottstown Borough (14.4%; representing 2,000 adults) are almost twice as likely to lack health insurance coverage as adults in the area overall (7.6%). The percentage of adults without insurance coverage is highest in Pottstown Borough (14.4%) and lowest in the Spring-Ford Area (3.5%). The percentage of adults in the Tri-County Areawithout insurance is lower than for adults in Berks (13.3%), Chester (8.9%), and Montgomery (8.1%)Counties.It does not meet the Healthy People 2020 goal of 100% of adults with health insurance coverage. The percentage of adults without insurance coverage is higher for adults living below 200% of the Federal Poverty Levelin the Tri-County Area compared with the non-poor (22.8% versus 4.3%). Nine out of 17 Key Informants identify low-income and uninsured individuals as a population that faces barriers to adequate access and services. In particular, Key Informants report that dental, behavioral health, preventive, and specialty care services are often inadequate for low-income individuals.7
Prescription Drug Coverage One in seven (14.1%) adults in the Tri-County Area does not have prescription drug coverage; this represents 24,800 adults. The percentage of adults without prescription drug coverage in the Tri-County Area is higher than the percentage without prescription coverage in Berks County (10.8%), but lower than in Montgomery (14.5%) and Chester (16.7%) Counties. Young adults ages 18-29 in the Tri-County Area are more likely not to have prescription drug coverage (19.2%) compared with adults ages 30-44 (15.5%), 45-64 (13.1%), and 65+ (11.3%).
7Because there are very few non-English speaking residents in the Tri-County Area, Key Informants feel that language barriers to health care are uncommon.
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Uninsured (92.6%) and poor adults (25.3%) in the Tri-County Area are much more likely not tohave prescription drug coverage compared with the insured (8.7%) and the non-poor (11.0%). Adults in Pottstown Boroughare most likely (20.4%) not to have prescription drug coverage, followed by adults in the Owen J. Roberts (16.8%), Daniel Boone (14.5%), Boyertown (14.2%), Spring-Ford (13.7%), Perkiomen Valley (9.1%), and Pottsgrove (8.4%) Areas.
Economic Barriers With or without health insurance, 25,300 adults in the Tri-County Areaare unable to get needed care due to the cost; 14.2% of adults report that there was a time in the past year when they needed health care, but did not receive it due to the cost (Figure 30). Adults in Pottstown Borough are more likely to lack prescription drug coverage(20.4%), to forego filling a prescription due to cost (21.9%), or not seek care due to transportation problems (7.0%) than adults in the other sub-areas. Uninsured (52.3%) and poor (25.7%) adults aremuch more likely not to seek health care due to cost than are insured (11.4%) and non-poor (11.0%) adults. About 27,200 adults in the Tri-County Area(15.3%) were prescribed a medication, but did not fill the prescription due to cost in the past year. Uninsured (37.3%) and poor (31.1%) adults are more likely not to fill a prescription due to the cost than were insured (14.1%) or non-poor (11.6%) adults (Figure 31).
Figure 31. Percentage of Tri-County Area Adults (18+) who Did NOT Fill a Prescription Due to Cost by Insurance and Poverty Status 40
35
30
25
20
37.3 Percent 15 31.1
10 15.3 14.1 5 11.6
0 Tri-County Area Uninsured Insured Poor Non-Poor
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poor=Below 200% of Federal Poverty Level.
In general, Key Informants describe overall access to health care services in the Tri-County Area as adequate, but identify some areas for improvement. Key Informants are divided as to whether or not there are enough primary care physicians in the area. There are no public health clinics near suburban areas, which can be problematic for low-income populations in these areas.Outpatient specialty care may be problematic for Medicaid managed care patients in some areas because not all specialty physicians participate in these plans. Key Informants (n=9) feel that low-income and uninsured individuals are more
36 The Center for Data Innovation PUBLIC HEALTH management corporation likely to have special healthcare access needs.Four Key Informants also identify affordable, accessible prescriptions as an unmet health need for many local residents.
About 6,800 adults (3.8%) in the Tri-County Area did not seek care in the past year due to transportation problems. Adults in Pottstown Borough (7.0%) are most likely to face transportation barriers to care and adults in the Owen J. Roberts Area are least likely (1.2%) to forego care for this reason. Young adults ages 18-29 (5.5%) are slightly more likely to experience transportation barriers to health care than adults 30 years of age or older. Adults living below 200% of the Federal Poverty Level (13.3%) and the uninsured (8.5%)are much more likely not to access needed care than adults at or above the poverty level (1.4%) and the insured (3.4%) due to transportation problems.
Key Informants commented that transportation is a barrier to care for many low-income residents. With the exception of Pottstown Borough, many Tri-County Area communities are not walkable because there are no sidewalks. There is also very little public transportation outside of the Borough and between suburban communities. In addition, due to “suburban sprawl,” many businesses are located in the suburbs, not in the center of Pottstown Borough. As a result, residents must drive to many locations, and if they do not have a car they may not be able to access needed services. There are some low cost transportation services available, although many residents may be unaware of how to access these services.
Nearly three in ten adults in the Tri-County Area (28.9%) did not visit a dentist in the past year; this percentage represents 51,300 adults. The percentage of adults who did not visit a dentist is highest (39.9%) for young adults ages 18-29 and lowest for adults ages 45-64 (24.5%) (Figure 32). The percentage of adults who did not visit a dentist is higher for uninsured (77.2%) and poor (45.8%) adults than for insured (25.2%) and non-poor (24.2%) adults.
Figure 32. Percentage of Tri-County Area Adults (18+) who Did NOT Visit a Dentist in Past Year by Insurance and Poverty Status 90 80 70 60 50 40 Percent 77.2 30 20 45.8 28.9 10 25.2 24.2 0 Tri-County Area Uninsured Insured Poor Non-Poor
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poverty=Below 200% of Federal Poverty Level.
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About 9,800 (17.9%) children in the Tri-County Area did not visit a dentist in the past year. This percentage is lower than the percentage for Chester (18.7%) and Montgomery (20.0%) Counties (Figure 33). The percentage of children who did not visit a dentist in the past year is highest for children 0-5 years of age (46.9%) compared with children 12-17 (8.3%) and children 6-11 (1.8%).
Figure 33. Percent of Tri-County Area Children (<18) who Did NOT Visit a Dentist in the Past Year by Age 50
45 46.9 40 35 30 25
Percent 20 15 17.9 10 5 1.8 8.3 0 Tri-County Area Ages 0-5 Ages 6-11 Ages 12-17
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
Key Informants report that poor oral health and access to dental care are issues among both children and adults in the Tri-County Area.They feel that dental problems in young children are caused by a lack of early and regular preventive care, poor tooth brushing, and poor diet. Adults may not make preventive dental care a priority due to cost, a lack of belief in the need for preventive care, and fear of the dentist. Adults may use the hospital emergency rooms either after dental offices have closed, or because they have no dentist.
However, many Key Informants describe availability and access to dental care in the region as adequate, citing plenty of dentists, hygienists, and clinics, as well as availability of services for uninsured patients. Community Health and Dental Care in Pottstown provides services on a sliding fee scale for uninsured patients, including $20 for a routine cleaning. They treat about 200-300 dental care patients each month.
Trends in Access to Care, 2008-2013 Barriers to accessing health care have increased slightly since 2008 across the Tri-County Area. For example, as shown in Figure 34, the percentage of adults who had no regular source of care or are uninsured rose from 8.6% to 9.7% and from 4.3% to 7.6%, respectively.
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Figure 34. Selected Barriers to Care for Tri-County Area Adults, 2008 & 2013
12% 9.7% 10% 8.6% 7.6% 8%
6%
4.3% Percent 4%
2%
0% No Regular Source of Care Uninsured 2008 2013 Sources: PHMC Pottstown Area Household Health Survey, 2008 (n=596), 2013 (n=1,501). Although the percentage of adults in the Tri-County Area with no regular source of care only increased slightly, from 8.6% to 9.7%, the percentage of adults experiencing this barrier to care increased greatly in the Boyertown Area, and also increased in the Pottsgrove and Owen J. Roberts Areas and in Pottstown Borough (Figure 35).
Figure 35. Percentage of Tri-County Area Adults with No Regular Source of Care, 2008 & 2013
20% 18% 18% 17% 16% 16% 14% 13% 13% 11% 12% 10% 10% 10% 10% 9% 8% 8%
Percent 8% 7% 5% 6% 4% 4% 2% 2% 0% Tri-County Boyertown Owen J. Perkiomen Pottsgrove Pottstown Spring-Ford Daniel Area Area Roberts Valley Area Area Borough Area Boone Area Area 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
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Utilization of Services Having a regular source of care is important since people who have a regular source of care are more likely to seek care when they are sick, as well as preventive care, compared with those who do not have a regular healthcare provider. In the Tri-County Area, one in ten (9.8%) adults does not have a regular source of care; this percentage represents approximately 17,500 adults (Figure 36). The overwhelming majority of children (96.9%) in the Tri-County Area have a regular source of care. Approximately 1,700 children in the service area do not have a regular source of care. Pottstown Borough (17.0%) has the highest percentage of adults who lack a regular source of care; this represents about 2,900 adults. o The Spring-Ford Area (4.4%) has the lowest percentage of adults without a regular source of care among the seven sub-areas. o The percentage of adults in the Tri-County Area with a regular source of care (90.2%) meets the Healthy People 2020 goal of 83.9%. Children in Pottstown Borough (10.9%) are more than three times as likely to lack a regular source of care as children in the area as a whole (3.1%). This represents 500 children in Pottstown Borough.
Figure 36. Percentage of Tri-County Area Adults (18+) with No Regular Source of Care by Insurance and Poverty Status 40
35
30
25
20
37.5 Percent 15
10 12.8 5 9.8 7.8 8.7 0 Tri-County Area Uninsured Insured Poor Non-Poor
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poverty=Below 200% of Fedreal Poverty Level.
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Health Behaviors
Nutrition According to the USDA’s MyPlate food guidelines, Americans should eat 4-5 servings of fruits and vegetables daily.8 According to one focus group participant, many individuals in the Tri-County Area are unaware of these guidelines:
“A lot of people they don’t know, it’s really public knowledge, it’s ironic, it’s right there on myplate.gov. It’s a big national website, it’s all there for you, it gives you recipes, little simple dishes, it gives you little tips and tricks to help you eat. Just to switch one of their meals a day, one step at a time, like switching out a bag of Doritos for a piece of fruit.” (Young adult group)
Focus group participants felt that education on nutrition could change people’s eating habits:
“Knowing what’s good for your body, knowing your body weight, total body fat, knowing if you want to maintain your weight or lose weight or gain weight and then know what foods to get, what diets. Being aware of your health, I think, will help people to eat healthier if they are more aware of what unhealthy foods actually do.” (Young adult group)
“If you teach kids to eat good food they will have better habits. Some people just don’t know how to eat healthy. People in general don’t know what’s a fun healthy snack, they think it has to be an apple or fruit. There’s other things out there that are healthy that kids can eat. You have to teach them to eat the colors of the rainbow.” (Underserved adult group)
Key Informants also agree that a lack of education regarding the importance of healthy eating and the availability of healthy foods is a barrier to healthy eating. According to Key Informants, many residents believe that healthier foods are more expensive. Other causes of poor nutrition, particularly among low- income residents, include cost, lack of time to prepare healthy meals, reliance on processed foods, smaller kitchen spaces, and limited knowledge of good nutrition and healthy cooking skills.
In the Tri-County Area,approximately seven in ten adults (69.8%) do not reach the recommended goal of eating 4-5 servings of fruits and vegetables daily(Figure 37). Adults in Pottstown Borough (80.6%) are least likely to consume four or more servings of fruits and vegetables a day compared to the six other sub-areas in the Tri-County Area. Adults between the ages of 30-44 are more likely not to reach this recommended goal compared with all other age categories (64.7% compared with 70.3% of adults 18-29 and 45-64 and 74.8% of adults 65+, respectively). The uninsured are more likely not to reach this recommended goal compared with the insured (75.5% compared with 69.1%, respectively).
8The U.S. Departments of Agriculture, (2011). Dietary Guidelines Consumer Brochure. Retrieved online on October 23, 2012 at http://www.choosemyplate.gov/foodgroups/downloads/MyPlate/DG2010Brochure.pdf
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Nationally, about three-quarters of adults (73.7%) do not eat three or more servings of fruits and vegetables daily9. Figure 37. Percentage of Pottstown Area Adults (18+) who Eat Less than Four Servings of Fruits and Vegetables a Day by Insurance and Poverty Status 100 90 80 70 60 50
Percent 40 75.5 69.8 69.1 72.3 68.8 30 20 10 0 Pottstown Area Uninsured Insured Poor Non-Poor
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey.
Two-thirds of children (68.0% or 31,300 children) in the Tri-County Area do not reach this recommended goal. Three-quarters of children (75.6%) between the ages of 12-17 eat three or fewer servings of fruit and vegetables in a typical day (Figure 38). Children living below 200% of the Federal Poverty Level are less likely to meet the USDA recommended goal than non-poor children (73.7% compared with 66.9%, respectively).
9U.S. Centers for Disease Control and Prevention. State-Specific Trends in Fruit and Vegetable Consumption Among Adults, 2000-2009 (2011).
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Figure 38. Percentage of Tri-County Area Children (<18) who Eat Less than Four Servings of Fruits and Vegetables a Day by Age
80
70
60
50
40 75.6 Percent 68.0 66.6 30 52.4 20
10
0 Tri-County Area Ages 0-5 Ages 6-11 Ages 12-17
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
Additionally, more than one in ten children (11.0%) in the Tri-County Area drinks sugary beverages more than once a day (Figure 39). Children 12 to 17 years old are more than four times as likely to drink sugary beverages more than once a day as children aged birth to 5 years old and 6 to 11 (21.4% compared with 4.9% and 4.7%, respectively). The percentage of poor children who drink sugary beverages more than once a day (20.8%) is more than double the percentage among non-poor children (8.7%).
In the judgment of Key Informants, unhealthy eating is common in the Tri-County Area. Most Key Informants feel that unhealthy eating is not confined to specific cultural groups in the Tri-County Area. Key Informants feel that children and teens do not eat healthy foods. Many students have the opportunity to eat a healthy breakfast and lunch in high school, and healthy snacks are available throughout many of the public schools, but this emphasis on healthful eating is not always reinforced at home.
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Figure 39. Percentage of Tri-County Area Children(<18) who Drink Sugary Beverages More than Once a Day by Age
25
20
15
Percent 10 21.4
5 11.0
4.9 4.7 0 Tri-County Area Ages 0-5 Ages 6-11 Ages 12-17
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
Many focus group participants also felt that both children and adults do not eat healthy food:
“No, the teens do not eat healthy. Sugar. Fast food, unhealthy foods are around every corner. It’s more convenient to eat fast food. It’s cheaper.” (Teen group)
“White flour, potatoes, breads, microwavable dinners and things like that, they have tons and tons of sodium and preservatives. Sodas – a lot of people are drinking sodas and they have a lot of sugar in them. They might not be eating healthy but what they drink, they consume so much sugar.” (Young adult group)
Other focus group participants felt that unhealthy food is cheaper, and many low-income residents cannot afford healthy food, or cannot get transportation to the grocery stores where healthy fresh fruits and vegetables are sold.
“McDonald’s hamburgers are cheaper than their salad, so we go for the burger.” (Teen group)
“I think it goes back to affording it. Some people want to eat healthy but can’t afford it; they have to get what they can get. Most unhealthy food is the cheapest thing”. (Underserved adult group)
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Focus group participants also felt that healthy food is not available in the restaurants in the Tri-County Area. “There’s not that many places around here that offer like healthier foods. Besides you might find a salad anywhere, but if you put a certain amount of dressing on it, it defeats the whole purpose of eating it. There’s not that many options for healthy foods around here unless you go to the grocery store. If I wanted to order from the local pizza shop or something, they don’t have anything healthy there.” (Young adult group)
In addition, the two most common sources of nutrition information used by adults in the Tri-County Area are the Internet (40.6%) and a physician or health care professional (26.3%). Younger adults between the ages of 18-29 and 30-44 are most likely to get nutrition information from the Internet (56% and 57.2%, respectively). Nearly one-half of uninsured adults (45.3%) rely on the Internet as their primary source for nutrition information (compared with 40.4% of insured adults); and 42.7% of non-poor adults rely on the Internet as their primary source of nutrition information, compared with 31.8% of poor adults (Figure 40).
Figure 40. Primary Source of Information on Nutrition for Tri-County Area Adults (18+)
45 40 35 30 25
20 40.6 Percent 15 26.3 10
5 7.4 7.4 9.0 0 Family or Physician or Written material Internet Don't look friends health care professional
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
In contrast to information sources for adult nutrition, the majority of parents (60.4%) report that their primary source of information on children’s nutrition is a physician or other health care professional. This percentage is significantly higher for information on nutrition for children 0-5 years of age (74.1% compared with 58.5% for children 6-11; and 50.5% for children 12-17). About one-fourth (24.0%) of parents rely on the internet for their primary source of information on children’s nutrition. Non-poor parents are more likely to use the internet as their primary source than poor adults (27.5% compared with 5.0%, respectively).
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According to the Economic Research Service within the USDA, limited access to affordable and nutritious food, and relatively easier access to less nutritious food, may be linked to poor diets and, ultimately,to obesity and diet-related diseases.10
According to Key Informants, poor nutrition among Tri-County Area residents is also related to transportation barriers to accessing fresh produce, the high cost of healthy foods at local grocery stores, and the ease of acquiring fast foods. Five Key Informants remarked that having a car significantly increases access to healthy foods, and it can be difficult to transport groceries if one has to take the bus.
In the Tri-County Area, 8,800 adults (4.9%) find it difficult or very difficult to find fruits or vegetables in their neighborhood. This percentage is highest among poor adults (11.3%), and those 65 years of age or older (8.0%). The Daniel Boone Area has the highest percentage of adults (14.0%) who find it difficult to find fruits or vegetables in their neighborhood compared with all other sub-areas.
“A lot of people would like to eat healthy but it is expensive. And if you don’t have a car it is harder to get to the cheaper supermarkets.” (Underserved adult group)
“A lot of people don’t have cars and stuff, so what is nearby is a corner store to get what you need to eat, they don’t have a lot of healthy options, they have frozen foods, little box stuff, TV dinners and all the unhealthy things. Before we had cars, we couldn’t bring back all the groceries. People that want to eat healthy but they had old habits, like, to buy a bottle of water is like a $1.39 but a soda at Mickey D’s [McDonald’s] is $1.00 for any size.” (Young adult group)
Key Informants’ opinions on whether residents have access to quality fresh fruits, vegetables, and other healthy foods are mixed. Some Key Informants feel that there are supermarkets and local farmer’s markets that provide the opportunity to purchase healthy foods, but that these resources might be underutilized. Other Key Informants cited a lack of quality grocery stores (and a multitude of neighborhood convenience stores) in Pottstown Borough as a specific barrier to accessing healthy foods. Key Informants noted that the cost of healthy food is a barrier to many lower income residents. Fast food is cheaper, and there are convenience stores throughout the region that sell products at low cost and are accessible without a car. Grocery stores in general, and healthy foods, are more available in the suburbs.
10United State Department of Agriculture: Economic Research Service (2009). Access to Affordable and Nutrition Food: Measuring and Understanding Food Deserts and their Consequences. Retrieved online on September 23, 2013 at http://www.ers.usda.gov/publications/ap-administrative-publication/ap-036.aspx#.UkCOOn-PySo
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Figure 41. Percentage of Tri-County Adults (18-64) who Rate the Overall Quality of Groceries in Neighborhood Stores as Fair or Poor by Insurance and Poverty Status 25
20
15
22.4 Percent 10 15.3 5 9.8 8.9 8.3
0 Tri-County Area Uninsured Insured Poor Non-Poor
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
For example, about one in ten (9.8%) Tri-County Area adults rate the overall quality of groceries in the area to be fair or poor (Figure 41). Pottstown Borough has a higher percentage of adults who rate the overall quality of groceries as fair or poor (17.7%). Fast foods are high in unhealthy calories, saturated fats, sugar, and salt. Two in five adults in the Tri-County Area (44.9%) eat fast food two or more times a week. Younger adults ages 18-29 are most likely to eat at fast food restaurants. Two-thirds of those between the ages of 18-29 (66.8%) have eaten at a fast food restaurant one or more times in the past week compared with 46.5% of adults 40-33; 43.3% of adults 45-64; and 30.6% of adults 65 and over. o The percentage of adults who eat fast food two or more times a week in Pottstown Borough (50.9%) and the Perkiomen Valley Area (49.8%) is higher than the percentage in the Tri-County Area as a whole and all other sub-areas. Focus group participants felt that fast food was very attractive in terms of time and money.
“Will power [and) time. Our culture, now, you can spend 20 minutes making a simple dish or go over to the fast food place and get it right away. It’s not only time but it’s also money. You don’t see a lot of kids walking around farmers markets shopping for fresh produces, you see them at the markets or fast food places.” (Young adult group) In addition, about two-thirds of adults (63.3%) in the Tri-County Area report that menu labeling does not influence their food choices. This percentage is fairly consistent for adults between the ages of 18-64. However, adults 65 years of age or older are even less likely to be influenced by menu labeling: 73.3% report that menu labeling does not influence their food choices. o More than three-quarters of adults in the Boyertown Area (75.7%) and a slightly lower percentage in Pottstown Borough (71.1%) report that menu labeling does not influence their food choices. These percentages are higher than the Tri-County Area as a whole and all other sub-areas.
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Focus group participants felt there are healthy choices in restaurants in the area, but felt that the smaller, low calorie portions were “less bang for your buck.”
“There are restaurants in the area that offer healthy choices and points for Weight Watchers and smaller portions. I know I eat more than I should. When you go out, you want more bang for your buck. I like to go to Friday’s, I have trouble ordering broccoli until I figured out that that’s the fattest food they have there, the broccoli – I was realizing that the butter they put on.” (Young adult group)
“A lot of restaurants changed their menus to low calorie. It may seem like a bad dish because they have smaller portions.” (Underserved adult group)
Focus group participants felt that the PAHWF could encourage healthy eating by encouraging more stores and farmer’s markets with healthy fresh produce and longer service hours in the Borough, by educating residents on healthy eating, and by holding cooking classes that teach healthy ways to cook fruit and vegetables that also taste good.
“Some way, somehow, educate people about everything that’s going on. Like healthy tips. Even if it’s holding another small group like this and just provide information.” (Young adult group)
“Make the groups more social, cooking lessons, stuff like that. They really need to advertise it. Some people read that Pottstown thing [the Mercury] that tells you what’s going on in the community but once a month it will come out, but you have to find a way to do it more often.“ (Young Adult Group)
“I think it’s important to educate parents on how to cook. Many people don’t know how to cook. So making things that taste good without pouring tons of stuff in it that’s bad for you but also being able to find it.” (Parent group)
“Farmers Markets, if they were open more. People can’t afford to always eat healthy. Discount prices. Food pantries.” (Young adult group)
Exercise The U.S. Department of Health and Human Services’ 2008 Physical Activity Guidelines for Americans recommends that adults (ages 18-64) get 2.5 hours of moderate aerobic physical activity each week.11
11U.S.Department of Health and Human Services.2008 Physical Activity Guidelines for Americans, 2008.
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Figure 42. Percentage of Tri-County Area Adults (18+) who Did NOT Exercise in the Past Month by Age 30
25
20
15
28.4 Percent 10 20.0 17.2
5 9.5 5.9 0 Tri-County Area Ages 18-29 Ages 30-44 Ages 45-64 Ages 65+
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
Approximately 30,700 adults (17.2%) in the Tri-County Area did not participate in any exercise in the past month. However, more than one-half (57.3%) of adults exercise three or more days a week as recommended. The Healthy People 2020 goal is to reduce the percentage of adults who participate in no leisure time physical activity to 32.6% (Figure 42). o Adults in the Daniel Boone Area (50.0%) are less likely to exercise three times a week than adults in the other six sub-areas. The percentage of adults who did not participate in any exercise in the past month in the Tri- County Area (17.2%) is greater than the percentage in Berks (15.6%), Chester (9.0%), and Montgomery (9.0%) Counties. In addition, the overwhelming majority of adults (82.3%) in the Tri-County Area do not participate in a worksite wellness program (Figure 43).
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Figure 43. Percentage of Tri-County Area Adults (18+) who Did NOT Participate in Worksite Wellness Program by Age and Poverty Status 100 90 80 70 60 50 96.9 92.8 90.5 Percent 40 82.3 76.6 80.0 81.1 30 20 10 0 Tri-County Ages 18-29 Ages 30-44 Ages 45-64 Ages 65+ Poor Non-poor Area
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
The U.S. Department of Health and Human Services’ 2008 Physical Activity Guidelines for Americans recommends that children and adolescents (ages 6-17) get 60 minutes or more of physical activity daily. Nearly one in eight children (12.2%) between the ages of 0-17 in the Tri-County Area exercise two or fewer times in a week. Specifically, adolescents between the ages of 12-17 are the most likely to exercises two or fewer times in a week (20.2% compared with 7% of childrenages 6-11 and 3.2% of children ages 0-5, respectively) (Figure 44). The Pottsgrove and Spring-Ford Areas have the highest percentages of children participating in physical activity two or fewer times per week than all other sub-areas (15.8% and 14.7%, respectively).
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Figure 44. Percentage of Tri-County Area Children (<18) who Were Not
Physically Active in the Past Week by Age 25
20
15
Percent 10 20.2
12.2 5 7.0 3.2 0 Tri-County Area Ages 0-5 Ages 6-11 Ages 12-17
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
Four Key Informants identify lack of physical exercise as negative health behavior. Key Informants feel that some people do not understand the importance of physical activity, and don’t realize that exercise can be free. The most commonly cited barriers to exercise by Key Informants include cost (n=9), transportation (n=8), and a lack of personal motivation (n=5).
Cost. One of the most commonly cited barriers to indoor exercise in inclement weather for Tri-County Area residents is the cost of gym membership. Transportation. Transportation to both indoor and outdoor activities is a barrier to exercise, according to eight Key Informants. For example, some parks and gym facilities are only accessible by car for those who live outside the immediate neighborhood. Even where public transportation may be available, cost and long distances between bus stops may be a barrier in poor weather. Lack of motivation. Facilities and programs encouraging exercise exist in the Tri-County Area, and that apathy or lack of motivation is the main barrier to a healthier lifestyle. Lack of knowledge about exercise. A lack of knowledge about the importance of exercise, as well as a lack of knowledge about where to go to exercise is another barrier to participation. Unsafe conditions. A lack of sidewalks and biking lanes in both urban and suburban areas makes it difficult to run, walk, or bike safely. Adults and children can safely bike on the trails, but must travel through dangerous traffic to get there. Daily struggles. When one is struggling day-to-day, as in many low-income households, healthy living and exercise often do not take priority. Lack of time. Focus group participants also feel that lack of time is a barrier to getting regular physical exercise.
“Like, because, for me, I barely work out. Sometimes I workout on my own time but I’m constantly going to school, walking to school, walking to work, so that’s exercising time. I work out in my room. I have a few little weights in my room.” (Young adult group)
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Cost and transportation are also barriers to working out for focus group participants, especially young adults.
“Transportation is the big thing. You have to wait a long time to catch a bus and then catch another bus by the time you get to the gym you’re tired out.” (Young adult group)
“[I do not exercise] because they [my parents] don’t have enough money. Not enough close [basketball] courts to get to. There is not much in walking distance to places. Bridge Street is the only one I know about.” (Teen group)
“There is no place that is free like a rec center like in the winter time where you don’t have to have a membership. Because the Y[MCA] memberships are really expensive. It really comes down to how valuable is your time, and two hours here and there a couple of times a week isn’t going to satisfy a membership. A place where you can go when you have time and fits around your schedule I think would be awesome. I know that comes down to how much does the city have, employment, and losing equipment and things like that, but it’s definitely out there.” (Young adult group)
Many parents felt that there were few family-based activities, and also that parents need to set a good example for their children, especially teenagers.
“I still feel one of the missing pieces especially in the suburbs is we all run our kids to soccer and this and that all the adults either go do errands or sit in their cars on their phones and there’s not a lot of family things so you can do something as a family because a lot of people work all day. Family activities. We do love to do family things that’s a huge factor if the family participates together.” (Parent group)
“Once they get around age 12 or 13, those are the ones hardest to get to exercise or go out and play. The ones I see walk by are under age 12 and I don’t see any teenagers as much.” (Parent group)
“We try to be active in our own yard, but there aren’t many kids around. We have to go and make that effort. So I think that going back to the parents to do it, I think parents want to, I don’t think they don’t want to, I think you have to seek it out and make it part of your life, make it important. If there are other factors in your life that override that, then I think it becomes very low on the important priority.” (Parent group)
In addition to family activities, focus group participants also suggested that better communication, a central source of information, and community-wide events would help people get more physically fit.
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“Even if it’s a free class, there’s marketing involved, getting the word out there, not to just certain people and places but everywhere out there, grocery stores, anywhere, post office, local churches, the Y and everywhere. Luckily through a group I have met, different women that I have asked, what can we do this summer that is relatively low cost, that I can take my kids that will be safe and active and something healthy for them and the whole family so it’s really hard to find that.” (Parent group)
“I think we have very little communications. You have to go to the calendar online or Facebook, the calendar for the school is not the best, so again you’re checking multiple places going back to knowing where things are being in Chester County we look at the Phoenixville calendar for what’s going on. You have all these different calendars; you got the parent resource coming home, that little brochure. There’s not one central place.” (Parent group)
Tobacco Use About one in five (19.3%) adults in the Tri-County Area currently smokes; this percentage is lower than the smoking rate statewide (22.4%) but is higher than for Southeastern Pennsylvania (SEPA) as a whole (18.2%) (Figure 45). The percentage of adult smokers is highest in Pottstown Borough (30.7%) compared with all other sub-areas. The percentage of smokers in the Tri-County Area is similar to the percentage in Berks County (20.4%) but higher than in Chester and Montgomery Counties (both 13.3%). Adults between the ages of 18-29 are more likely to smoke than any other age group (24.7% compared with 21.8% of adults 30-44; 19.4% of adults 45-64; and 11.8% of adults 65 and over, respectively). In addition, adults living below 200% of the Federal Poverty Level in the Tri-County Areaaretwice as likely to smoke as non-poor adults (33.5% compared with 15.3%, respectively). The percentage of adults in the Tri-County Area who smoke does not meet the Healthy People 2020 goal of 12.0%.12 The majority (59.2%) of adults in the area who smoke tried to quit in the past year.
122011 Behavioral Risks of Pennsylvania Adults, PA Department of Health.
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Figure 45. Percentage of Tri-County Area Adults (18+) who Smoke Cigarettes by Age and Poverty Status 40 Key 35
30
25
20
Percent 33.5 15 24.7 21.8 10 19.3 19.4 15.3 5 11.8
0 Tri-County Ages 18-29 Ages 30-44 Ages 45-64 Ages 65+ Poor Non-poor Area Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey. Poverty=Below 2005 of Federal Poverty Level. Informants were asked their opinion on positive health behaviors among residents. The most common positive health behaviors include increased use of biking, walking and river trails;reduction in smoking rates; and organization and participation in healthy community activities. Among Key Informants, the most commonly cited health behavior with a negative health impact was substance use, including alcohol, tobacco, and other drugs. Key Informants believe strongly in the relationship between poverty, stress, depression, low educational attainment, and a pervasive acceptance of drug and alcohol use, including cigarette smoking.
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Screen Time The American Academy of Pediatrics discourages media use by children younger than age two and recommends limiting older children's screen time to no more than one or two hours a day. Studies have shown that excessive screen time has been linked to obesity, irregular sleep, behavior problems, impaired academic performance, and violence.13
Nearly one-third of children in the Tri-County Area watch more than two hours of television per day,and 17.8% of children in the Tri-County Areause the computer for more than two hours per day. Nearly one-half (44.4%) of children between the ages of 12-17 watch two or more hours of television per day; an additional 33.3% use the computer for more than two hours per day. 54.2% of children in the Pottsgrove Area watch two or more hours of television per day. This percentage is higher than the Tri-County Areaaverage and any other sub-area. In addition, the Pottsgrove Area has the highest percentage of children using the computer for two or more hours per day (33.7%). The percentage of children watching two or more hours of television per day in the Tri-County Area is higher than in Chester and Montgomery Counties (31.3% compared with 23.4% and 26.3%, respectively).
In addition, four in ten adults (41.5%) in the Tri-County Area watch more than two hours of television per day. Adults living below 200% of the Federal Poverty Level are more likely to watch two or more hours of television than non-poor adults (50.3% compared with 39.8%, respectively). One in ten adults in the Tri-County Areauses the computer for more than two hours per day. o The percentage of adults who use the computer for more than two hours per day is highest among adults ages 18-29 (38.9%). o Uninsured adults are more likely to use the computer for more than two hours per day compared with adults with health insurance (35.4% compared with 17.0%, respectively).
Social Capital About one-third of adults (32.9%), or nearly 58,300 adult residents in the Tri-County Area, report low social capital in their neighborhood.Nearly one in five (19.1%) adults in Pottstown Borough does not go somewhere during the day due to safety; this is nearly three times the percentage in the overall Tri- County Area (6.6%). Pottstown Borough has the highest percent of adults who report low social capital (42.2%), followed by the Boyertown Area (41.2%). The percentage of adults in the Tri-County Area who report low social capital in their neighborhood (32.4%) is higher than in Chester and Montgomery Counties (25.3% and 24.1%, respectively). In addition, three-quarters of adults(74.5%) have not heard of the PAHWF.
Public Recreation Approximately 106,400 adult residents (59.8%) do not use public recreation facilities in the Tri-County Area. Two in ten adults feel uncomfortable visiting a neighborhood outdoor space or park during the day.
13 2013 Media and Children, The American Academy of Pediatrics. Retrieved on September 24, 2031 at http://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/Media-and-Children.aspx
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Three-quarters of adults in the Daniel Boone Area (77.7%) and two-thirds of adults in the Boyertown Area (67.6%) do not use recreation facilities in the Tri-County Area; this is the highest percentage in the Tri-County Area. Uninsured and poor adults, and those age 65 and older (80.9%), are more likely not to utilize these recreation facilities as well(Figure 46).
Figure 46. Percentage of Tri-County Area Adults (18+) who Did NOT Use Public Recreation Facilities in the Pottstown Area by Age 90 80 70 60 50
40 80.9 Percent 30 59.8 61.6 53.4 20 43.0 10 0 Tri-County Area Ages 18-29 Ages 30-44 Ages 45-64 Ages 65+
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Survey
Key Informants’ opinions regarding whether or not Tri-County Arearesidents have enough safe, affordable places for outdoor or indoor exercise are mixed. Some Key Informants report that there are plenty of safe and affordable indoor and outdoor spaces for exercise, and others feel that there are not enough public playgrounds or organized outdoor sporting events. Several Key Informants suggested that there are enough public places for exercise, such as playgrounds, parks with fitness equipment, and trails, but that these places are not being used frequently. Residents might benefit from more outreach about available resources.
According to Key Informants, characteristics of people who exerciseregularly are that they: Are employed and/or have high-incomes; Have transportation (cars); Are motivated to improve their physical health; and Are educated about the benefits of exercise.
According to Key Informants, Tri-County Area residents who exercise indoors most often go to: A YMCA branch (n=9). Some Key Informants mentioned that membership fees, even at the Y, may be too expensive for some. Key Informants suggested an increase in Y scholarship programs or free memberships. Local gyms (n=4). Some Key Informants noted, however, that gym access is not free, and some private health clubs are cost prohibitive for many.
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Senior Centers (n=2). Private Swim Club (n=1). Olivet Boys and Girls Club (n=1).
Outdoor exercise opportunities in the Tri-County Areareported by Key Informants include: Walking and biking trails (n=10). Key Informants report that the biking and walking trails, such as the Schuylkill River Trail and the Perkiomen Trail, are accessible and popular outdoor exercise options. Public parks and playgrounds (n=10). Among the most popular outdoor public spaces for exercise are local parks and playgrounds. As one Key Informant noted, Pottstown Borough has an excellent Recreation Department, with parks in every neighborhood except for the North End. Key Informants feel that the playgrounds are safe and the equipment is in good condition. For younger children, in particular, there are great opportunities for play. School facilities (n=3). School facilities, such as tracks and playgrounds, are viable outdoor exercise resources for many residents. Bike share program (n=2). Two Key Informants and many focus group participants listed the free Bike Share Program as a tremendous resource in the area. The Bike Share Program, with PAHWF funding, bought 25 bicycles and distributed them in two locations – an office at the Schuylkill River Trail and a bike shop in town.
Trends in Health Behaviors, 2008-2013 Since 2008, smoking among Tri-County Area adults has increased slightly, from 16.5% to 18.5% (Figure 47). However, the percentage of adults who exercise less than three times a week has decreased slightly (43.0% and 41.7%, respectively).
Figure 47. Selected Health Behaviors for Tri-County Area Adults, 2008 & 2013
80% 69.2% 68.6% 70% 60% 50% 43.0% 41.7% 40%
Percent 30% 18.5% 20% 16.5% 10% 0% Smokes Exercise < 3 Day/Week Fruits & Vegetables < 4/Day 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
The percentage of adults who exercise less than the recommended three days a week decreased in Pottstown Borough from 58.2% to 44.6% between 2008 and 2013, but increased in the Owen J. Roberts, Perkiomen Valley, and Daniel Boone Areas (Figure 48).
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Figure 48. Percentage of Tri-County Area Adults who Exercise <3 Days/Week, 2008 & 2013
70% 58% 60% 49% 50% 45% 46% 45% 50% 44%42% 44% 44% 39% 39% 39% 38%38% 38% 40%
30% Percent 20% 10% 0% Tri-County Boyertown Owen J. Perkiomen Pottsgrove Pottstown Spring-Ford Daniel Area Area Roberts Valley Area Area Borough Area Boone Area Area 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
Since 2008, the percentage of adults who eat less than four fruits and vegetables a day has increased in only one sub-area, Pottstown Borough, from 71.2% to 80.6% (Figure 49).
Figure 49. Percentage of Tri-County Area Adults who Eat <4 Fruits or Vegetables/Day, 2008 & 2013 90% 81% 76% 77% 80% 72% 72%74% 70% 70% 71% 69% 67%68% 69% 70% 64%64% 63% 60% 50%
40% Percent 30% 20% 10% 0% Tri-County Boyertown Owen J. Perkiomen Pottsgrove Pottstown Spring-Ford Daniel Area Area Roberts Valley Area Area Borough Area Boone Area Area 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013.
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Health Screenings
Regular health screenings can help identify problems before they start. Early detection can improve chances for treatment and help individuals to live longer, healthier lives.
Key Informants were asked to describe any barriers to receiving preventive screenings for Tri-County Area residents. The greatest barriers to preventive screenings identified included insurance coverage/screening cost (n=6), the location of screening services and available transportation (n=5), awareness of screening availability, including free or reduced cost services (n=3), and a lack of personal motivation to complete screenings (n=2).
Recommended Screenings
Blood Pressure In the Tri-County Area, 9.4% of residents 18 years of age or older did not have a blood pressure test in the past year, representing approximately 16,600 adults. This percentage is comparable withthat of Chester County (9.0%) and lower than that of Montgomery and Berks Counties (10.7% and 13.2% respectively). The Boyertown Area has the highest percentage of adults who have not had a blood pressure test in the past year (15.1%). Younger adults (ages 18-29) are more likely not to have had their blood pressure tested in the past year (15.9%), compared with adults ages 30-44 (12.8%), 45-64 (8.4%), and 65 and over (3.1%). Figure 50. Percentage of Tri-County Area Adults (18+) who Did NOT Have a Blood Pressure Test in the Past Year by Insurance Status 40 35 30 25 20 35.2 Percent 15 10 5 9.4 7.6 0 Tri-County Area Uninsured Insured
Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area
Uninsured adults are nearly five times as likely not to have had a blood pressure test in the past year (35.2%) compared with insured adults (7.6%) (Figure 50).
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Blood Cholesterol Three in ten adults aged 18 and older (30.1%) did not have a blood cholesterol test in the past year; this percentage represents approximately 51,700 adults. Adults (18+) in the Daniel Boone Area are the most likely not to have had a blood cholesterol check in the past year (39.8%). Adults between the ages of 18-29 are the most likely not to have had their blood cholesterol checked in the past year (57.3%), followed by adults 30-44 (40.7%), 45-64 (26.1%), and 65 and over (9.8%). More than one-half of uninsured adults (18+) did not have a blood cholesterol check in the past year (54.9%) in comparison with 28.3% of insured adults.
Colonoscopy and Sigmoidoscopy Regular screenings beginning at age 50 are fundamental in preventing colorectal cancer. Of adults 50 years of age or older, three in ten (31.5%) did not have a colonoscopy or Sigmoidoscopy in the past ten years, which represents 27,200 adults. Adults aged 50+ in Perkiomen Valley Area are the most likely not to have had a colonoscopy or Sigmoidoscopy in the past year (89.9%). Adults aged 50+ in the Tri-County Area are slightly more likely not to have had a colonoscopy or Sigmoidoscopy in the past ten yearscompared with adults in Berks (30.6%), Montgomery (26.3%), and Chester (28.6%) Counties. Reviewing screening in the past year, 83.1% of Tri-County Area adults (50+) have not been screened. Nearly 100% of uninsured adults age 50+ did not have a colonoscopy or Sigmoidoscopy in the past year (99.2%), compared with82.3% of insured adults. Figure 51. Percentage of Tri-County Area Adult Women (18+) who Did Not Receive a Pap Test in the Past Year by Insurance Status
80 70 60 50 40 75.1
Percent 30 20 45.0 43.8 10 0 Tri-County Area Uninsured Insured Source: PHMC's 2012 Southeastern Pennsylvania Household Health Survey and 2013 Pottstown Area Household Health Pap Test More than four in ten women 18 years of age or older did not have a Pap test in the past year (45.0%), representing approximately 40,100 women (Figure 51). More than one-half of women (18+) in the Boyertown Area did not have a Pap test in the past year (55.4%); women (18+) in Owen J. Roberts Area were the least likely not to have been screened in the past year (37.1%) compared with the other sub-areas.
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More than one-half of women between the ages of 18-29 did not have a Pap test in the past year (51.9%). This number decreases for women ages 30-44 (28.2%) and then increases again for women ages 45-64 (43.7%) and 65 and over (63.2%). Three-quarters of uninsured women (18+) did not have a Pap test in the past year (75.1%) compared with 44.0% of insured women. In addition, women (18+) living below 200% of the Federal Poverty Level are less likely to have had a Pap test in the past year (55.5%) compared with42.2% of non-poor women.
Mammogram The American Cancer Society recommends annual mammograms beginning at age 40 for women in good health, although longer intervals for screening have recently been recommended by other organizations.
Approximately 28,800 women 40 years of age or older did not have a mammogram in the past year (43.2%). This percentage is comparable with that of Berks and Chester Counties (40.6% and 40.3% respectively), but higher than for women (40+) in Montgomery County (34.8%). Women in the Daniel Boone and Boyertown Areas were the most likely to have gone without mammograms (52.3% for both). Seven in ten uninsured women (40+) did not have a mammogram in the past year (70.8%) compared with 41.5% of insured women.
PSA/Rectal Exam Thirty-seven percent of men aged 45 and older in the area (36.9%) did not have a PSA or rectal exam for prostate cancer in the past year, representing approximately 15,300 men. Men (45+) in the Tri-County Area (36.9%) are less likely to have been screened for prostate cancer in the past year compared with men in Chester (42.3%), Montgomery (44.3%), and Berks (47.4%) Counties. More than one-half of men (45+) in Pottstown Borough (55.0%) were not tested for prostate cancer in the past year, which is comparable with that of the Daniel Boone Area (52.9%), but higher than for the other sub-areas. Nearly one-half of men between the ages of 45-64 were not tested for prostate cancer in the past year (46.6%), compared with 17.9% of men age 65 or older. Eight in ten uninsured men (45+) did not have a PSA or rectal exam in the past year in comparison with 34.9% of men with health insurance. In addition, 45.7% of men (45+) living below 200% of the Federal Poverty Level did not have a PSA or rectal exam in the past year compared with 34.7% of non-poor men.
Trends in Health Screenings, 2008-2013 The percentage of adults who did not receive recommended screenings, such as for oral health problems (23.6% versus 28.5%), and cervical (32.8% versus 45.3%) and breast (32.1% versus 42.8%) cancer, in the Tri-County Area increased between 2008 and 2013 (Figure 52).
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Figure 52. Selected Health Screenings for Tri-County Area Adults, 2008 & 2013
50% 45.3% 45% 42.8% 40% 35% 32.8% 32.1% 28.5% 30% 23.6% 25%
Percent 20% 15% 10.7% 9.3% 10% 5% 0% Dentist Visit >1 Year BP Check >1 Year Pap Smear >1 Year Mammogram >1 Year 2008 2013 Sources: PHMC Berks County Survey, 2008 ; PHMC Pottstown Area Survey, 2008, 2013. Pap smear= women 18+; Mammorgram=women 40+
The health care, recreational, nutritional, and social service resources in the Tri-County Area that are available to address these gaps in health status and access to care are discussed in the next section, Existing Resources.
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EXISTING RESOURCES
Public Health Resources Pennsylvania has a total of six county and four city health departments. The purpose of public health departments is to prevent disease, protect people from hazards to their health, and promote healthy living through an organized, community-based approach. Health departments conduct health screenings, ensure environmental and food safety, monitor and test for communicable diseases, administer immunizations, support maternal and child health, and provide health education. Local health departments ensure that these services are provided to the public using an organized approach. Services are provided free or at low cost to the general public in order to reach as many residents as possible. The nearest Montgomery County Health Department office is located in Norristown.
Acute Care Acute care resources located in the Tri-County Area include one for-profit acute care general hospital (Pottstown Memorial Medical Center in Pottstown). Pottstown Memorial Medical Center is a 234-bed general medical and surgical hospital in Pottstown, offering a full range of health services including inpatient and outpatient, medical and surgical, and diagnostic and emergency care. In fiscal year 2012, the hospital served patients through approximately 43,500 emergency room visits, 10,000 admissions, 129,500 outpatient visits, and 4,200 inpatient surgeries.14
Phoenixville Hospital is a 137-bed non-profit general medical and surgical hospital in Phoenixville, which is located just outside of the Tri-County Area.The hospital has clinical partnerships with the University of Pennsylvania Health System, The Children's Hospital of Philadelphia, The Philadelphia Hand Center, the Moore Eye Institute, and Abington Memorial Hospital. Annually, the hospital provides comprehensive medical services through approximately 25,000 emergency room visits, 8,200 inpatient admissions, and more than 500 community outreach programs.15Phoenixville Hospital has four Outpatient Centers and employs 161 active physicians.16In 2012, its physicians performed 3,492 inpatient and 9,947 outpatient surgeries.17There were 621 and 887 births at each hospital, respectively, in fiscal year 2012.18
Acute care resources in the Reading Area in Berks County include two not-for-profit acute care general hospitals (St. Joseph Regional Health Network in Bern Township and Reading Health System in West Reading), which are approximately 15 miles from Pottstown Borough. Both acute care general hospitals are teaching hospitals that are located just outside the municipal boundaries of the City of Reading. St. Joseph Regional Health Network admitted 8,122 inpatients and reported 226,586 outpatient (emergency and non-emergency) visits in fiscal year 2012.19 St. Joseph Regional Health Network consists of: A 204 acute care bed facility, located in Bern Township; 20 outpatient centers, including physician offices, diagnostic, and therapeutic satellite locations; 100 employed physician and mid-level providers; and
14 U.S. News Best Hospitals Rankings, available at http://health.usnews.com/best-hospitals/area/pa/pottstown- memorial-medical-center-6232770 15 Phoenixville Hospital website, http://www.phoenixvillehospital.com 16 Phoenixville Hospital Fact Sheet, available at the hospital website, phoenixvillehospital.com. 17U.S. News Best Hospitals Rankings, available at http://health.usnews.com/best-hospitals/area/pa/phoenixville- hospital-6232390/details 18 U.S. News Best Hospitals Rankings, available at http://health.usnews.com/best-hospitals/area/pa/ 19 Pennsylvania Health Care Cost Containment Council, 2012.
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A comprehensive ambulatory care facility in downtown Reading.
Reading Health System has: 600 acute care beds; 40 primary care and diagnostic centers; The Center for Mental Health including a 35-bed psychiatric hospital (adult and adolescent beds); and a 110-bed post-acute hospital.
There were 800 and 3,586 births at each hospital, respectively, in fiscal year 2011.
Primary Care Primary care patient medical homes are an important resource in ensuring continuous and comprehensive care that can prevent or ameliorate chronic disease. Montgomery County, where Pottstown Borough and several other sub-areasin the Tri-County Area are located, has a higher ratio of primary care physicians per person, 747:1, compared with both the state and the nation as a whole. On the other hand, Berks County, where several sub-areas in the Tri-County Area are located, has fewer primary care physicians per person than Pennsylvania as a whole. According to the County Health Rankings,20 the ratio of primary care physicians to the population of Berks County is 1,580:1. This is lower than the U.S. ratio of 1,067:1 and the Pennsylvania ratio of 1,273:1.Chester County, the location of the Owen J. Roberts Area, fares slightly better, with a ratio of 1,175:1.
However, the mere presence of more primary care physicians does not ensure that more individuals in the population get primary care.21
In addition to the providers listed above, access to primary care for low-income residents of the Tri- County Area is also provided at a Federally Qualified Health Center,Community Health & Dental Care, Inc. in Pottstown. Services provided by Community Health & Dental Care, Inc. include: women’s health exams, flu shots, on-site lab services, on-site pharmacy, childhood immunizations, preventive screenings, pediatric care, case management and referral assistance, and dental services for adults and children. In addition to Community Health & Dental Care Inc., dental care is available to low-income residents through the Community Medical and Dental Center Rahns, located in Rahns, Montgomery County.
Other Health Care Services Primary episodic care services are also provided by three urgent care centers: Premier Immediate Medical Care in Douglasville, Premier Urgent Care in Limerick, and Premier Immediate Medical Care in Royersford.
20www.countyhealthrankings.org , 2013. 21Shi, L. and Starfield, B. The Effect of Primary Care Physician Supply and Income Inequality on Mortality Among Blacks and Whites in US Metropolitan Areas. American Journal of Public Health. August 2001, Vol. 91, No. 8, pp. 1246-1250.
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Social Services
As shown in Appendix E, there are many social service agencies in the Tri-County Area, including mental health services, substance abuse treatment, homeless/emergency shelters, and nutrition services.
Five agencies provide mental health and substance abuse services to Tri-County Area residents, offering recovery oriented behavioral health and supportive services through individual, group and family therapy. Four of these agencies are located in Pottstown: Pennsylvania Forensic Associates (mental health services), Rehab After Work - Outpatient Treatment Centers (substance abuse services), and Resources For Human Development (substance abuse services). Creative Health Services Inc., in Pottstown provides substance abuse and mental health services through outpatient, intensive outpatient, residential treatment, case management and children’s programs as well as other services. Spring-Ford Counseling Services in Royersford offers various counseling sessions, programs and treatments for individuals and families to meet their mental health and substance abuse needs.
There are three senior centers in the Tri-County Areawhich provide health, education, arts, and fitness programming; information and referrals; assistance with grocery shopping; socialization opportunities; and communal meals for older adults. There is one center in Pottstown, Pottstown Area Senior Center. There are also two senior centers in Berks County, Berks Encore located in Birdsboro and The Center at Spring Street in Boyertown.
There are two shelter programs in the Tri-County Area for homeless men, women, women with children, and entire families. The Ministries at Main Street provides seasonal homeless shelter services in Pottstown.The Berks County Housing Authority offers shelter and housing services in Birdsboro.
The Tri-County Area has several agencies and organizations that provide services directed to improving nutrition. Three Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) offices in the area, located in Boyertown, Pottstown, and Spring City, provide supplemental nutritious foods, information on healthy eating, including breastfeeding promotion and support, and referrals to health care for low-income pregnant, postpartum, and breastfeeding women, infants, and children up to age five who are at nutritional risk.
The Pottstown Cluster of Religious Communities supplies food, community meals, dry goods, support and referrals and financial assistance for individuals and families. Services include: an Emergency Food Pantry which provides food and infant formula; a Community Meals Program with complete weekday and holiday lunches and dinners, cooked and served by volunteers; a Dry Goods Department with clothing, shoes, personal hygiene items and housewares; an emergency financial assistance program; Meals on Wheels; the Getting Ahead Initiative, an educational program on overcoming poverty; personal care; and support and referrals to community social agencies and health care.
Other non-profit agencies that provide services to a substantial number of Tri-County Area residents include the Salvation Army and the Pottstown Family Center.
The Pottstown Family Center offers a wealth of programs for families and children. These programs include: Alternative Response, which provides support to families who have a concrete need for assistance;The Parent-Child Playgroup;Parents As Teachers Home Visitation; Parent Education;The PEAK (Pottstown Early Action for Kindergarten Readiness) Initiative, which works with the Tri-County Area to
65 The Center for Data Innovation PUBLIC HEALTH management corporation coordinate community early childhood education and related services and make them more readily available; the Pregnant and Parenting Teen Program; the SHARE Food Program, which gives community members quality food at affordable costs; the Time-Limited Family Reunification Program; the Toy and Book Lending Library; and the Volunteer Income Tax Assistance (VITA) program offers free income tax preparation to low-income families.
The Salvation Army of Pottstown provides many services, including adoption and foster care, adult rehabilitation, community centers, children’s camps, residential supports for persons with developmental disabilities, emergency disaster services, music and arts programming, emergency shelter and transitional housing, and social services, including food pantries, soup kitchens, and meal services.
Nutritional Resources
Nutritional assistance is provided through the 16 food pantries and other meal programs distributed throughout the Tri-County Area, including five in Pottstown Borough. There are food pantry locations throughout the Tri-County Areain Boyertown, Stowe, Schwenksville, Spring City, Glenmoore, and Royersford. Many food pantries, soup kitchens, and meal programs are located in churches.
Twenty chain grocery store locations, including Acme Markets, ALDI, Costco, Genuardi’s, Giant Food, Redner’s Market, Super Fresh, Thriftway, Walmart, Wegmans, Weis Markets, and Whole Foods Market, are situated in the Tri-County Area. These chain grocery stores are located in Chester Springs, Royersford, Pottstown, Boyertown, Collegeville, Douglassville, Bechtelsville, and Gilbertsville.However, none of these chain grocery stores are located in the downtown area of Pottstown Borough, making shopping for those without a car difficult.
There are 23 farmers’ markets and produce stands providing access to fresh produce in the Tri-County Area, although all are located in either Montgomery or Chester Counties. In Montgomery County, seven farmers’ markets or produce stands are located in Collegeville, five are located in Pottstown, three are in Gilbertsville, and one is in Frederick. In Chester County, three farmers’ markets or produce stands are located in Chester Springs, two are in Elverson, one is in Spring City, and one is located in Glenmoore.
Currently, the Pottstown Community Garden at 4th and Chestnut Streets is the only community garden in the area. The community garden staffs a farm stand each fall to sell the vegetables they have grown, along with other fresh produce and locally harvested honey. The Pottstown Community Garden is scheduled to expand to a second location.
Public Schools
There are seven school districts serving Tri-County Area students in grades K-12: Pottstown School District, which serves approximately 3,200 students; Pottsgrove School District, a suburban district serving approximately 3,350 students; Daniel Boone School District, which serves a student population of approximately 3,900; Owen J. Roberts School District, serving approximately 5,000 students from seven townships; Spring-Ford Area School District, serving more than 7,700 students from Montgomery and Chester Counties; Perkiomen Valley School Districtserving nearly 5,900 students in the communities ofCollegeville, Lower Frederick, Perkiomen, Schwenksville, Skippack, andTrappe; and Boyertown Area School District, which serves over 7,000 students spread out across a geographically widespread farming district that is shifting to a more suburban residential community.
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Parks and Recreation Services
There is an abundance of township and municipal parks available for public use (more than 130 public parks) in the Tri-County Area. These parks offer access to: playgrounds; walking, hiking and biking trails; pavilions and amphitheaters; restroom facilities; spray parks; basketball and tennis courts; baseball, softball, football, and soccer fields; fitness stations; street hockey; BMX tracks and skate parks; volleyball courts; picnics; boating access; and fishing and wildlife. There are also three state parks, two dog parks, two outdoor municipal pools and 11 outdoor public school running tracks in the Tri-County Area.
Additional Resources
There are five YMCA and one YWCA locations throughout the Tri-County Area. All of the YMCAs are located in Montgomery County. Philadelphia Freedom Valley YMCA locations in the Tri-County Area include: Pottstown, Limerick, Gilbertsville, and Upper Perkiomen Valley. Another YMCA serves the Boyertown Area. YMCAs provide programming for children, adults, and seniors, including: group fitness classes; personal training; aquatics instruction and pool use; childcare and pre-school activities; youth and teen activities; sports programming, summer camp; and massage therapy. The YWCA Tri-County, located in Pottstown, aims to empower women and families and to eliminate racism. YWCA programs include the Adult Literacy Center, day care for young children, and Women Excel, a business and professional women’s networking and support group.
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VI. COMMUNITY HEALTH AND WELLNESS NEEDS
The health and wellness needs for the Tri-County Area were identified and prioritized by comparing the health status, access to care, health behaviors, and utilization of services for residents of the service area with results for the surrounding counties. Input from focus groups and Key Informant interviews were also used to further identify and prioritize unmet needs.
Overall, the health status and access to care of Tri-County Area adults and children compares favorably with health indicators for surrounding Montgomery, Chester, and Berks County, the Commonwealth, and the U.S. Surgeon General’s Healthy People 2020 goals for the nation. However, the health of Pottstown Borough adults and children is substantially worse than the health of residents of the Tri-County Area as a whole. Tri-County Area adults and children who are poor or uninsured also experience poorer health.
For some health indicators, the findings for the service area are statistically significantly worse than the surrounding region, comprised of Berks, Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties and, therefore should be prioritized for improvement. These indicators are:
Pap test in past year (p<0.05); Mammogram in past year (p<0.01); Low social capital (p<0.01); and (Child) dental visit in past year (age 4-17) (p<0.01).
Data from Vital Statistics, the Tri-County Area Household Health Survey, Key Informant interviews, and Focus Groups identified two key areas of unmet needs: obesity/overweight and access to care. Healthy behaviors, such as eating habits and physical activity, have a direct effect on an individual’s weight. There is an unmet need for more programming that will improve health behaviors in the Tri-County Area.
Health Behaviors
Healthy Eating Several health behaviors in the Tri-County Area represent unmet needs for education and services. Health education is also a top priority among Key Informants and many focus group participants. In the Tri-County Area, approximately seven in ten adults (69.8%) do not reach the USDA’s MyPlate food guidelines of 4-5 servings of fruits and vegetables a day. Additionally, the majority of children (68% or 31,300 children) in the Tri-County Area do not reach this recommended goal.Key Informants and focus group participants attributed poor nutrition to cost, education, lack of time, different priorities and preferences, and transportation problems.
To help Tri-County Area residents eat healthier foods, PHMC recommends the following: Increase public knowledge about healthy foods and their availability, including farmers’ markets. Ensure that the educational campaign emphasizes the role parents play in healthy behaviors in children. Increase access to fresh produce through more affordable local farmers markets. Expand community gardens. Bring in an affordable grocery store in downtown Pottstown. Work with community groups to promote healthy eating behaviors.
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Physical Activity Nearlyone in eight children (12.2%) between the ages of 0-17 in the Tri-County Area exercised two or fewer times in the past week. The U.S. Department of Health and Human Services’ 2008 Physical Activity Guidelines for Americans recommends that children and adolescents (ages 6-17) get 60 minutes or more of physical activity daily. The Pottsgrove and Spring-Ford Areas have the highest percentage of children participating in physical activity two or fewer times per week than all other sub-areas (15.8% and 14.7%, respectively). Focus groups and key informant interviews identified cost, transportation, motivation, and time, among other issues, as barriers to exercise.
Nearly one-third of children in the Tri-County Area watch more than two hours of television per day; an additional 17.8% of children in the Tri-County Area use the computer for more than two hours per day.Studies have shown that excessive screen time has been linked to obesity, irregular sleep, behavior problems, impaired academic performance, and violence. Approximately 106,400 adult residents (59.8%) do not use public recreation facilities in the Tri- County Area.Uninsured and poor adults are more likely not to utilize these recreation facilities (64.8% and 74.2%, respectively).
One-half of children in poverty are overweight or obese, which may indicate difficulty accessing healthy foods, poor diet, and/or lack of access to safe places for play. Obesity rates also differ between lower and higher income areas.
To help Tri-County Area residents exercise, PHMC recommends the following strategies: Increase the use of existing faith communities to educate and provide physical activity opportunities, because many adults and families in the region belong to a church. Provide more low cost or free opportunities for adults, teens, and young adults to participate in organized sports. Use social media to promote more group physical activities, especially for youth and young adults. Provide a central electronic resource center for information on physical activities, and promote its existence using social media and other forms of publicity. Encourage residents to make exercise a priority, such as through a public awareness campaign. Reach more children through schools and by educating more parents on the importance of modeling a healthy lifestyle. Increase healthy family activities and programs for children.
Access to Health Care
Many adults in the Tri-County Area have unmet needs for physical and behavioral health care. Key Informants mentioned difficulty accessing care, particularly due to economic and transportation problems.
Insurance coverage is a barrier to care nationally. In the Tri-County Area, a sizable number of adults do not have any private or public health insurance; 7.8% of adults aged 18-64 in the service area are uninsured, representing 11,300 adults.
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With or without health insurance, 25,300 adults in the Tri-County Area are unable to get needed care due to the cost of that care; 14.2% of adults reported that there was a time in the past year when they needed health care, but did not receive it due to the cost. One in seven (14.1%) adults in the Tri-County Area does not have prescription drug coverage; this represents 24,800 adults. And about 27,200 adults in the Tri-County Area were prescribed a medication but did not fill the prescription due to cost in the past year. Finally, about 6,800 adults (3.8%) in the Tri-County Area did not seek care in the past year due to transportation problems. Uninsured adults with mental health conditions may not be accessing services. Uninsured adults are less likely to get preventive health screenings overall when compared with insured adults.
Many of these priority unmet needs are already being addressed in the Tri-County area. This information can be used to improve health and wellness in the Tri-County Area in the next few years, working within the changing national healthcare environment.
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APPENDIX A: LIST OF KEY INFORMANTS
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Tri-County Area Community Health Needs Assessment List of Key Informants
Richard Saylor, M.D. Chief Medical Officer Pottstown Memorial Medical Center Pottstown, PA
Bridgette Madden Chief Executive Officer Community Health and Dental Care Pottstown, PA
William H. Ball, III Pastor Mount Olive Baptist Church Pottstown, PA
Melissa D. Patschke, Ed.D. Principal Health and Wellness Coordinator Upper Providence Elementary School Royersford, PA
Mary Rieck Pottstown Early Action for Kindergarten (PEAK) Coordinator Tri-County Area Pottstown, PA
Mark Flanders Borough Manager Pottstown, PA
Kurt Zwikl Executive Director Schuylkill River Greenways Association Pottstown, PA
Kay Dougherty Former Board Member Tri-County Area Health and Wellness Foundation Pottstown, PA
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Karen Youse Executive Director Boyertown Area Multi-Service Center Boyertown, PA
JoAnn Rechtin Health and Wellness Coordinator Community Engagement Specialist Owen J. Roberts Area Pottstown, PA
Jennifer M. Doyle, M.P.A. Executive Director TriCounty Community Network Pottstown, PA
Evan Brandt Reporter The Mercury Pottstown, PA
Eileen Dautrich President TriCounty Area Chamber of Commerce Pottstown, PA
Barbara Wilhelmy Executive Director Pottstown Cluster of Religious Communities Pottstown, PA
Ann Marie Traynor, Ed.D. Former Assistant to the Superintendent Daniel Boone Area Birdsboro, PA
Andrew Trentacoste, Ph.D., M.B.A. Chief Executive Officer Creative Health Services Pottstown, PA
Adamino Ortiz President Emeritus Former Executive Director AccíonComunal Latino Americano de Montgomery County (ACLAMO) Family Centers Pottstown, PA Norristown, PA
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APPENDIX B: U.S. CENSUS TABLES
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Tri-County Area
Table 1. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 193,542 228,856 233,441 240,040 Freq. % Freq. % Freq. % Freq. %
0-17 50,206 25.9 57,631 25.2 58,167 24.9 58,728 24.5
18-44 77,711 40.2 78,649 34.4 77,627 33.3 76,391 31.8 Age 45-64 43,090 22.3 64,648 28.2 67,220 28.8 69,767 29.1
65+ 22,535 11.6 27,928 12.2 30,427 13.0 35,154 14.6
Male 96,823 50.0 114,092 49.9 116,313 49.8 119,485 49.8 Gender Female 96,719 50.0 114,764 50.1 117,128 50.2 120,555 50.2
White 176,717 91.3 200,120 87.4 201,877 86.5 204,049 85.0
Black 9,622 5.0 12,573 5.5 13,093 5.6 13,957 5.8
Race/Ethnicity* Asian 1,867 1.0 5,505 2.4 6,434 2.8 7,824 3.3
Other 2,221 1.1 4,019 1.8 4,468 1.9 5,184 2.2
Latino 3,115 1.6 6,639 2.9 7,569 3.2 9,026 3.8
English N/A N/A 197,583 94.4 204,461 93.7 210,070 93.7
Spanish N/A N/A 3,426 1.6 4,548 2.1 4,622 2.1 Language Asian N/A N/A 2,070 1.0 2,376 1.1 2,450 1.1 Spoken at Language Home Other European N/A N/A 5,333 2.5 6,222 2.9 6,401 2.9 Language Other N/A N/A 964 0.5 547 0.3 562 0.3
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
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Table 2. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 193,542 228,856 233,441 240,040 Freq. % Freq. % Freq. % Freq. %
Less than HS 19,870 15.2 15,326 10.3 13,269 8.5 13,394 8.4
Education HS graduate 77,089 59.2 87,062 58.4 89,677 57.4 91,500 57.3
College or more 33,345 25.6 46,586 31.3 53,411 34.2 54,793 34.3
Employed 98,868 95.6 118,363 95.9 119,663 92.8 124,030 92.9 Employment Unemployed 4,519 4.4 5,039 4.1 9,231 7.2 9,549 7.1
Families living in 1,707 3.4 2,456 4.1 2,398 3.9 2,455 3.9 poverty Poverty Status Families living in poverty with 1,317 5.1 1,893 6.1 1,820 5.8 1,851 5.7 children
Renter-occupied 16,156 22.8 18,111 21.5 18,420 21.5 18,905 21.5 Housing Unit Type Owner-occupied 54,840 77.2 66,085 78.5 67,106 78.5 68,932 78.5 Commute to 60 min. or more 9,615 10.2 12,979 11.6 14,008 12.1 14,453 12.1 Work Median Household Income $57,670 $64,866 $75,911 $81,663
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
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Pottstown Borough
Table 3. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 21,894 22,377 22,444 22,532 Freq. % Freq. % Freq. % Freq. %
0-17 5,610 25.6 5,333 23.8 5,419 24.1 5,615 24.9
18-44 8,402 38.4 8,414 37.6 8,249 36.8 7,963 35.3 Age 45-64 4,337 19.8 5,623 25.1 5,673 25.3 5,633 25.0
65+ 3,545 16.2 3,007 13.4 3,103 13.8 3,321 14.7
Male 11,493 52.5 11,646 52.0 11,645 51.9 11,638 51.7 Gender Female 10,401 47.5 10,731 48.0 10,799 48.1 10,894 48.3
White 16,962 77.5 15,377 68.7 14,975 66.7 14,342 63.7
Black 3,225 14.7 4,147 18.5 4,322 19.3 4,609 20.5
Race/Ethnicity* Asian 140 0.6 196 0.9 208 0.9 226 1.0
Other 576 2.6 872 3.9 956 4.3 1,074 4.8
Latino 991 4.5 1,785 8.0 1,983 8.8 2,281 10.1
English N/A N/A 19,535 94.2 19,606 94.3 18,564 93.9
Spanish N/A N/A 631 3.2 911 4.4 913 4.4 Language Asian N/A N/A 47 0.2 42 0.2 116 0.6 Spoken at Language Home Other European N/A N/A 228 1.1 229 1.1 351 1.8 Language Other N/A N/A 7 0.0 7 0.0 7 0.0
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
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Table 4. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 21,894 22,377 22,444 22,532 Freq. % Freq. % Freq. % Freq. %
Less than HS 3,369 23.0 2,367 16.7 2,272 15.1 2,271 15.0
Education HS graduate 9,471 64.7 9,595 67.8 10,115 67.2 10,170 67.4
College or more 1,807 12.3 2,197 15.5 2,655 17.7 2,656 17.6
Employed 10,431 95.2 10,194 95.6 10,809 89.9 10,722 89.9 Employment Unemployed 524 4.8 465 4.4 1,212 10.1 1,204 10.1
Families living in 519 9.4 621 11.5 537 9.7 532 9.6 poverty Poverty Status Families living in poverty with 442 15.2 536 18.4 413 13.8 411 13.6 children
Renter-occupied 4,012 43.8 4,169 44.7 4,222 45.0 4,292 45.3 Housing Unit Type Owner-occupied 5,147 56.2 5,152 55.3 5,166 55.0 5,179 54.7 Commute to 60 min. or more 731 7.1 796 8.0 979 9.3 968 9.3 Work Median Household Income $36,150 $43,656 $44,340 $46,533
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
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Pottsgrove Area
Table 5. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 19,073 21,248 21,566 22,047 Freq. % Freq. % Freq. % Freq. %
0-17 5,342 28.0 5,440 25.6 5,403 25.1 5,372 24.4
18-44 7,239 38.0 7,313 34.4 7,242 33.6 7,104 32.2 Age 45-64 4,214 22.1 5,901 27.8 6,093 28.3 6,270 28.4
65+ 2,278 11.9 2,594 12.2 2,828 13.1 3,301 15.0
Male 9,290 48.7 10,328 48.6 10,496 48.7 10,746 48.7 Gender Female 9,783 51.3 10,920 51.4 11,070 51.3 11,301 51.3
White 17,122 89.8 17,972 84.6 17,990 83.4 17,996 81.6
Black 1,276 6.7 1,827 8.6 1,939 9.0 2,116 9.6
Race/Ethnicity* Asian 163 0.9 334 1.6 371 1.7 429 1.9
Other 251 1.3 519 2.4 580 2.7 680 3.1
Latino 261 1.4 596 2.8 686 3.2 826 3.7
English N/A N/A 19,079 95.3 19,506 95.3 18,867 95.1
Spanish N/A N/A 199 1.0 203 1.0 301 1.5 Language Asian N/A N/A 153 0.8 153 0.7 162 0.8 Spoken at Language Home Other European N/A N/A 473 2.4 484 2.4 397 2.0 Language Other N/A N/A 126 0.6 130 0.6 119 0.6
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
5
PUBLIC HEALTH management corporation
Table 6. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 19,073 21,248 21,566 22,047 Freq. % Freq. % Freq. % Freq. %
Less than HS 1,931 15.4 1,443 10.3 1,355 9.4 1,370 9.3
Education HS graduate 7,717 61.5 8,629 61.5 9,115 63.2 9,322 63.2
College or more 2,896 23.1 3,959 28.2 3,957 27.4 4,063 27.5
Employed 9,824 95.5 11,435 96.1 11,244 91.9 11,559 91.8 Employment Unemployed 462 4.5 462 3.9 993 8.1 1,030 8.2
Families living in 268 5.1 359 6.1 327 5.5 322 5.3 poverty Poverty Status Families living in poverty with 214 7.5 297 9.2 308 10.1 301 9.7 children
Renter-occupied 1,340 19.3 1,446 18.4 1,473 18.4 1,516 18.5 Housing Unit Type Owner-occupied 5,593 80.7 6,433 81.6 6,521 81.6 6,669 81.5 Commute to 60 min. or more 1,033 10.9 1,327 12.1 1,746 16.2 1,790 16.1 Work Median Household Income $54,731 $71,634 $71,976 $76,283
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
6
PUBLIC HEALTH management corporation
Daniel Boone Area
Table 7. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 17,390 21,249 21,452 21,803 Freq. % Freq. % Freq. % Freq. %
0-17 4,682 26.9 5,789 27.2 5,693 26.5 5,555 25.5
18-44 6,600 38.0 7,002 33.0 6,925 32.3 6,871 31.5 Age 45-64 4,187 24.1 5,862 27.6 6,049 28.2 6,288 28.8
65+ 1,921 11.0 2,596 12.2 2,785 13.0 3,089 14.2
Male 8,631 49.6 10,559 49.7 10,658 49.7 10,826 49.7 Gender Female 8,759 50.4 10,690 50.3 10,794 50.3 10,977 50.3
White 16,675 95.9 19,582 92.2 19,579 91.3 19,568 89.7
Black 253 1.5 561 2.6 625 2.9 736 3.4
Race/Ethnicity* Asian 79 0.5 281 1.3 327 1.5 394 1.8
Other 198 1.1 314 1.5 336 1.6 375 1.7
Latino 185 1.1 511 2.4 585 2.7 730 3.3
English N/A N/A 18,731 95.6 19,216 95.7 19,505 95.8
Spanish N/A N/A 235 1.2 476 2.4 472 2.3 Language Asian N/A N/A 130 0.7 46 0.2 46 0.2 Spoken at Language Home Other European N/A N/A 498 2.5 326 1.6 331 1.6 Language Other N/A N/A 1 0.0 16 0.1 15 0.1
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
7
PUBLIC HEALTH management corporation
Table 8. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 17,390 21,249 21,452 21,803 Freq. % Freq. % Freq. % Freq. %
Less than HS 1,869 16.0 1,624 11.9 1,167 8.3 1,176 8.3
Education HS graduate 7,468 64.0 8,724 63.9 9,065 64.8 9,203 64.8
College or more 2,335 20.0 3,304 24.2 3,748 26.8 3,819 26.9
Employed 9,193 96.9 11,422 96.6 11,138 92.5 11,460 92.5 Employment Unemployed 298 3.1 396 3.4 907 7.5 927 7.5
Families living in 121 2.5 206 3.5 238 4.1 244 4.1 poverty Poverty Status Families living in poverty with 105 4.2 175 6.0 186 6.2 192 6.3 children
Renter-occupied 1,176 18.4 1,342 17.7 1,343 17.7 1,353 17.7 Housing Unit Type Owner-occupied 5,222 81.6 6,239 82.3 6,234 82.3 6,297 82.3 Commute to 60 min. or more 890 10.1 1,362 12.7 1,473 13.9 1,509 13.8 Work Median Household Income $57,128 $72,165 $71,656 $72,019
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
8
PUBLIC HEALTH management corporation
Owen J. Roberts Area
Table 9. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 26,860 32,804 33,682 34,912 Freq. % Freq. % Freq. % Freq. %
0-17 6,760 25.2 8,273 25.2 8,286 24.6 8,219 23.5
18-44 9,237 34.4 9,930 30.3 9,900 29.4 10,052 28.8 Age 45-64 7,145 26.6 10,228 31.2 10,612 31.5 10,833 31.0
65+ 3,718 13.8 4,373 13.3 4,884 14.5 5,808 16.6
Male 13,414 49.9 16,364 49.9 16,781 49.8 17,362 49.7 Gender Female 13,446 50.1 16,440 50.1 16,901 50.2 17,550 50.3
White 25,770 95.9 30,407 92.7 30,968 91.9 31,727 90.9
Black 479 1.8 827 2.5 897 2.7 997 2.9
Race/Ethnicity* Asian 162 0.6 485 1.5 571 1.7 691 2.0
Other 227 0.8 443 1.4 495 1.5 576 1.6
Latino 222 0.8 642 2.0 751 2.2 921 2.6
English N/A N/A 29,945 95.1 30,102 95.2 31,154 95.2
Spanish N/A N/A 258 0.8 478 1.5 484 1.5 Language Asian N/A N/A 299 0.9 228 0.7 235 0.7 Spoken at Language Home Other European N/A N/A 818 2.6 798 2.5 827 2.5 Language Other N/A N/A 178 0.6 24 0.1 22 0.1
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
9
PUBLIC HEALTH management corporation
Table 10. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 26,860 32,804 33,682 34,912 Freq. % Freq. % Freq. % Freq. %
Less than HS 2,386 12.9 1,829 7.9 1,318 5.8 1,356 5.7
Education HS graduate 10,220 55.1 12,363 53.3 11,927 52.1 12,302 51.9
College or more 5,934 32.0 9,023 38.9 9,632 42.1 10,026 42.3
Employed 13,432 97.3 17,327 97.0 17,575 93.7 18,447 93.7 Employment Unemployed 369 2.7 536 3.0 1,763 6.3 1,230 6.3
Families living in 246 3.3 428 4.6 329 3.6 343 3.6 poverty Poverty Status Families living in poverty with 169 4.9 275 6.4 227 5.1 236 5.1 children
Renter-occupied 1,915 19.4 2,358 19.5 2,417 19.6 2,509 19.7 Housing Unit Type Owner-occupied 7,973 80.6 9,705 80.5 9,905 80.4 10,212 80.3 Commute to 60 min. or more 1,240 9.9 1,767 11.0 1,883 11.6 1,969 11.5 Work Median Household Income $63,304 $85,300 $85,327 $94,623
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
10
PUBLIC HEALTH management corporation
Spring-Ford Area
Table 11. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 36,450 47,368 49,096 51,598 Freq. % Freq. % Freq. % Freq. %
0-17 9,716 26.7 12,633 26.7 13,030 26.5 13,480 26.1
18-44 15,826 43.4 16,720 35.3 16,584 33.8 16,366 31.7 Age 45-64 7,235 19.8 12,828 27.1 13,760 28.0 14,926 28.9
65+ 3,673 10.1 5,187 11.0 5,722 11.7 6,826 13.2
Male 17,753 48.7 23,123 48.8 23,982 48.8 25,234 48.9 Gender Female 18,697 51.3 24,245 51.2 25,114 51.2 26,364 51.1
White 34,137 93.7 41,462 87.5 42,256 86.1 43,281 83.9
Black 815 2.2 1,664 3.5 1,872 3.8 2,216 4.3
Race/Ethnicity* Asian 658 1.8 2,364 5.0 2,818 5.7 3,515 6.8
Other 362 1.0 780 1.6 883 1.8 1,058 2.1
Latino 478 1.3 1,098 2.3 1,267 2.6 1,528 3.0
English N/A N/A 38,525 93.1 41,376 90.5 43,506 90.5
Spanish N/A N/A 650 1.6 959 2.1 997 2.1 Language Asian N/A N/A 688 1.7 1,294 2.8 1,358 2.8 Spoken at Language Home Other European N/A N/A 1,132 2.7 1,862 4.1 1,947 4.1 Language Other N/A N/A 383 0.9 235 0.5 249 0.5
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
11
PUBLIC HEALTH management corporation
Table 12. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 36,450 47,368 49,096 51,598 Freq. % Freq. % Freq. % Freq. %
Less than HS 2,683 10.9 2,082 7.1 1,823 5.6 1,880 5.5
Education HS graduate 13,519 54.9 15,594 52.8 16,997 52.1 17,680 52.2
College or more 8,439 34.2 11,844 40.1 13,812 42.3 14,315 42.3
Employed 20,177 97.5 25,204 97.9 25,786 93.1 27,269 93.1 Employment Unemployed 509 2.5 548 2.1 1,919 6.9 2,036 6.9
Families living in 174 1.8 232 1.9 312 2.4 322 2.4 poverty Poverty Status Families living in poverty with 137 2.5 186 2.8 212 3.1 216 3.0 children
Renter-occupied 3,299 23.9 3,927 22.0 4,032 21.9 4,198 21.9 Housing Unit Type Owner-occupied 10,531 76.1 13,959 78.0 14,340 78.1 15,008 78.1 Commute to 60 min. or more 2,077 10.8 2,813 11.8 2,719 11.0 2,869 11.0 Work Median Household Income $63,892 $88,857 $84,376 $93,353
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
12
PUBLIC HEALTH management corporation
Perkiomen Valley Area
Table 13. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 31,356 37,677 38,433 39,409 Freq. % Freq. % Freq. % Freq. %
0-17 7,535 24.0 9,193 24.4 9,376 24.4 9,540 24.2
18-44 15,346 48.9 14,847 39.4 14,535 37.8 14,055 35.7 Age 45-64 6,228 19.9 10,098 26.8 10,579 27.5 11,162 28.3
65+ 2,247 7.2 3,539 9.4 3,943 10.3 4,652 11.8
Male 17,162 54.7 20,212 53.6 20,529 53.4 20,882 53.0 Gender Female 14,194 45.3 17,465 46.4 17,904 46.6 18,527 47.0
White 26,720 85.2 31,322 83.1 31,730 82.6 32,220 81.8
Black 3,067 9.8 3,048 8.1 2,934 7.6 2,732 6.9
Race/Ethnicity* Asian 463 1.5 1,390 3.7 1,622 4.2 1,967 5.0
Other 363 1.2 599 1.6 663 1.7 767 1.9
Latino 743 2.4 1,318 3.5 1,484 3.9 1,723 4.4
English N/A N/A 32,020 93.2 33,057 91.8 33,884 91.9
Spanish N/A N/A 795 2.3 1,019 2.8 1,034 2.8 Language Asian N/A N/A 377 1.1 474 1.3 478 1.3 Spoken at Language Home Other European N/A N/A 1,041 3.0 1,311 3.6 1,343 3.6 Language Other N/A N/A 124 0.4 130 0.4 129 0.3
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
13
PUBLIC HEALTH management corporation
Table 14. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 31,356 37,677 38,433 39,409 Freq. % Freq. % Freq. % Freq. %
Less than HS 2,936 14.1 2,192 9.3 1,690 6.8 1,672 6.6
Education HS graduate 11,160 53.4 12,213 52.0 12,264 49.1 12,342 48.9
College or more 6,785 32.5 9,071 38.6 11,048 44.2 11,208 44.4
Employed 14,383 88.7 17,506 89.6 18,641 94.8 19,421 94.8 Employment Unemployed 1,835 11.3 2,029 10.4 1,023 5.2 1,062 5.2
Families living in 174 2.4 237 2.7 338 3.7 351 3.7 poverty Poverty Status Families living in poverty with 114 2.8 157 3.4 233 4.7 239 4.6 children
Renter-occupied 1,760 17.8 1,777 14.9 1,820 14.9 1,886 14.9 Housing Unit Type Owner-occupied 8,122 82.2 10,179 85.1 10,379 85.1 10,747 85.1 Commute to 60 min. or more 1,708 12.4 2,270 13.7 2,386 12.2 2,453 12.2 Work Median Household Income $69,883 $94,448 $92,961 $99,869
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
14
PUBLIC HEALTH management corporation
Boyertown Area
Table 15. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 40,519 46,133 46,768 47,739 Freq. % Freq. % Freq. % Freq. %
0-17 10,561 26.1 10,970 23.8 10,960 23.4 10,947 22.9
18-44 15,061 37.2 14,423 31.3 14,192 30.3 13,980 29.3 Age 45-64 9,744 24.0 14,108 30.6 14,454 30.9 14,655 30.7
65+ 5,153 12.7 6,632 14.4 7,162 15.3 8,157 17.1
Male 20,172 49.8 22,775 49.4 23,068 49.3 23,541 49.3 Gender Female 20,347 50.2 23,358 50.6 23,700 50.7 24,198 50.7
White 39,331 97.1 43,998 95.4 44,379 94.9 44,915 94.1
Black 507 1.3 499 1.1 504 1.1 551 1.2
Race/Ethnicity* Asian 202 0.5 455 1.0 517 1.1 602 1.3
Other 244 0.6 492 1.1 555 1.2 654 1.4
Latino 235 0.6 689 1.5 813 1.7 1,017 2.1
English N/A N/A 40,931 95.3 42,096 95.7 42,909 95.7
Spanish N/A N/A 556 1.3 506 1.2 518 1.2 Language Asian N/A N/A 298 0.7 134 0.3 138 0.3 Spoken at Language Home Other European N/A N/A 1,096 2.6 1,224 2.8 1,240 2.8 Language Other N/A N/A 47 0.1 9 0.0 10 0.0
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
15
PUBLIC HEALTH management corporation
Table 16. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 40,519 46,133 46,768 47,739 Freq. % Freq. % Freq. % Freq. %
Less than HS 4,696 17.2 3,789 12.3 3,644 11.2 3,669 11.2
Education HS graduate 17,534 64.0 19,944 64.6 20,194 62.3 20,481 62.3
College or more 5,149 18.8 7,188 23.2 8,559 26.4 8,706 26.5
Employed 21,428 97.6 24,275 97.7 24,470 92.4 25,152 92.4 Employment Unemployed 522 2.4 603 2.3 2,004 7.6 2,060 7.6
Families living in 205 1.8 373 2.9 317 2.4 341 2.5 poverty Poverty Status Families living in poverty with 136 2.4 267 4.2 241 3.9 256 4.1 children
Renter-occupied 2,654 17.8 3,092 17.7 3,113 17.6 3,151 17.5 Housing Unit Type Owner-occupied 12,252 82.2 14,418 82.3 14,561 82.4 14,820 82.5 Commute to 60 min. or more 1,936 9.5 2,644 11.1 2,822 12.1 2,895 12.1 Work Median Household Income $54,883 $71,576 $69,152 $72,265
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
16
PUBLIC HEALTH management corporation
Berks County
Table 17. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 373,638 411,442 414,193 418,339 # % # % # % # %
0-17 91,909 (24.6) 98,136 (23.9) 96,516 (23.3) 94,880 (22.7)
18-44 140,980 (37.7) 141,140 (34.3) 140,705 (34.0) 140,718 (33.6) Age 45-64 84,559 (22.6) 112,608 (27.4) 113,592 (27.4) 112,180 (26.8)
65+ 56,190 (15.0) 59,558 (14.5) 63,380 (15.3) 70,561 (16.9)
Male 182,956 (49.0) 201,864 (49.1) 203,159 (49.0) 205,129 (49.0) Gender Female 190,682 (51.0) 209,578 (50.9) 211,034 (51.0) 213,210 (51.0)
White 317,025 (84.8) 316,406 (76.9) 310,624 (75.0) 302,093 (72.2)
Black 12,478 (3.3) 16,517 (4.0) 17,267 (4.2) 18,475 (4.4)
Race/Ethnicity* Asian 3,713 (1.0) 5,244 (1.3) 5,527 (1.3) 5,904 (1.4)
Other 4,065 (1.1) 5,920 (1.4) 6,323 (1.5) 6,937 (1.7)
Latino 36,357 (9.7) 67,355 (16.4) 74,452 (18.0) 84,930 (20.3)
English N/A N/A 324,576 (85.1) 323,776 (83.3) 326,764 (83.4)
Language Spanish N/A N/A 40,504 (10.6) 47,785 (12.3) 47,940 (12.2) Spoken at Asian N/A N/A 2,612 (0.7) 3,165 (0.8) 3,180 (0.8) Home Language
Other N/A N/A 13,864 (3.6) 13,865 (3.6) 13,940 (3.6)
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
17
PUBLIC HEALTH management corporation
Table 18. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 373,638 411,442 414,193 418,339 # % # % # % # %
Less than HS 54,651 (22.0) 46,556 (17.1) 42,986 (15.7) 43,650 (15.7)
Education HS graduate 148,202 (59.6) 165,193 (60.5) 169,624 (61.9) 172,689 (61.9)
College or more 46,011 (18.5) 61,261 (22.4) 61,554 (22.5) 62,465 (22.4)
Employed 180,881 (94.9) 206,721 (94.6) 197,088 (90.3) 200,220 (90.3) Employment Unemployed 9,671 (5.1) 11,879 (5.4) 21,259 (9.7) 21,597 (9.7)
Families living in 6,172 (6.3) 8,544 (8.0) 10,823 (10.2) 10,906 (10.2) Poverty poverty Status Families living in 4,942 (10.3) 6,895 (13.3) 9,015 (17.9) 9,071 (17.9) poverty with children
Renter-occupied 36,851 (26.0) 43,703 (28.3) 43,840 (28.4) 44,165 (28.4) Housing Unit Type Owner-occupied 104,719 (74.0) 110,653 (71.7) 110,632 (71.6) 111,088 (71.6) Commute to 60 min. or more 9,815 (5.7) 13,888 (7.2) 14,953 (7.9) 15,189 (7.9) Work Median Household Income $45,118 $54,775 $51,448 $51,546
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
18
PUBLIC HEALTH management corporation
Chester County
Table 19. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 433,501 498,886 509,675 524,577 Freq. % Freq. % Freq. % Freq. %
0-17 113,582 (26.2) 124,055 (24.9) 124,080 (24.3) 123,382 (23.5)
18-44 166,042 (38.3) 167,808 (33.6) 167,546 (32.9) 168,881 (32.2) Age 45-64 103,200 (23.8) 143,148 (28.7) 147,848 (29.0) 149,455 (28.5)
65+ 50,677 (11.7) 63,875 (12.8) 70,201 (13.8) 82,859 (15.8)
Male 212,739 (49.1) 245,161 (49.1) 250,390 (49.1) 257,559 (49.1) Gender Female 220,762 (50.9) 253,725 (50.9) 259,285 (50.9) 267,018 (50.9)
White 377,925 (87.2) 409,561 (82.1) 412,368 (80.9) 415,683 (79.2)
Black 26,395 (6.1) 29,388 (5.9) 29,587 (5.8) 29,519 (5.6)
Race/Ethnicity* Asian 8,400 (1.9) 19,216 (3.9) 21,948 (4.3) 26,089 (5.0)
Other 4,655 (1.1) 8,218 (1.6) 9,133 (1.8) 10,538 (2.0)
Latino 16,126 (3.7) 32,503 (6.5) 36,639 (7.2) 42,748 (8.1)
English N/A N/A 418,025 (89.3) 421,292 (88.2) 433,227 (88.2)
Language Spanish N/A N/A 19,797 (4.2) 26,730 (5.6) 27,330 (5.6) Spoken at Asian N/A N/A 9,605 (2.1) 10,618 (2.2) 10,836 (2.2) Home Language
Other N/A N/A 20,652 (4.4) 19,196 (4.0) 19,670 (4.0)
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
19
PUBLIC HEALTH management corporation
Table 20. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 433,501 498,886 509,675 524,577 Freq. % Freq. % Freq. % Freq. %
Less than HS 30,576 (10.7) 24,246 (7.3) 24,692 (7.3) 25,425 (7.3)
Education HS graduate 133,888 (46.8) 148,540 (44.7) 146,489 (43.5) 151,418 (43.6)
College or more 121,352 (42.5) 159,684 (48.0) 165,691 (49.2) 170,841 (49.1)
Employed 221,255 (96.4) 261,832 (96.1) 261,549 (94.1) 271,920 (94.1) Employment Unemployed 8,214 (3.6) 10,697 (3.9) 16,449 (5.9) 17,081 (5.9)
Families living in 3,710 (3.3) 4,829 (3.7) 4,759 (3.6) 4,900 (3.6) poverty Poverty Status Families living in poverty with 2,728 (4.6) 3,143 (4.8) 3,381 (5.1) 3,472 (5.1)
children
Renter-occupied 37,477 (23.7) 43,572 (23.8) 44,551 (23.9) 45,936 (24.0) Housing Unit Type Owner-occupied 120,428 (76.3) 139,328 (76.2) 141,794 (76.1) 145,483 (76.0) Commute to 60 min. or more 18,528 (8.9) 24,201 (9.8) 24,255 (9.9) 25,185 (9.9) Work Median Household Income $65,996 $85,389 $85,554 $92,894
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
20
PUBLIC HEALTH management corporation
Montgomery County
Table 21. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 750,097 799,874 809,053 822,203 Freq. % Freq. % Freq. % Freq. %
0-17 181,145 (24.1) 183,499 (22.9) 183,286 (22.7) 182,630 (22.2)
18-44 281,973 (37.6) 267,385 (33.4) 263,919 (32.6) 260,802 (31.7) Age 45-64 175,182 (23.4) 228,263 (28.5) 233,294 (28.8) 233,804 (28.4)
65+ 111,797 (14.9) 120,727 (15.1) 128,554 (15.9) 144,967 (17.6)
Male 362,554 (48.3) 387,964 (48.5) 392,569 (48.5) 399,188 (48.6) Gender Female 387,543 (51.7) 411,910 (51.5) 416,484 (51.5) 423,015 (51.4)
White 640,019 (85.3) 631,784 (79.0) 626,936 (77.5) 619,176 (75.3)
Black 55,303 (7.4) 67,582 (8.4) 70,247 (8.7) 74,266 (9.0)
Race/Ethnicity* Asian 30,126 (4.0) 51,354 (6.4) 56,447 (7.0) 63,856 (7.8)
Other 9,349 (1.2) 14,921 (1.9) 16,357 (2.0) 18,554 (2.3)
Latino 15,300 (2.0) 34,233 (4.3) 39,066 (4.8) 46,351 (5.6)
English N/A N/A 654,214 (89.2) 669,076 (87.9) 679,404 (88.0)
Language Spanish N/A N/A 16,948 (2.3) 23,062 (3.0) 23,284 (3.0) Spoken at Asian N/A N/A 22,771 (3.1) 27,506 (3.6) 27,739 (3.6) Home Language
Other N/A N/A 39,600 (5.4) 41,309 (5.4) 41,847 (5.4)
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
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Table 22. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 750,097 799,874 809,053 822,203 Freq. % Freq. % Freq. % Freq. %
Less than HS 59,307 (11.5) 41,948 (7.8) 39,186 (7.0) 39,773 (7.0)
Education HS graduate 256,777 (49.8) 259,216 (48.4) 269,687 (48.2) 274,348 (48.3)
College or more 199,787 (38.7) 234,304 (43.8) 250,134 (44.7) 253,861 (44.7)
Employed 384,688 (95.5) 410,333 (96.1) 418,816 (93.3) 427,658 (93.3) Employment Unemployed 17,965 (4.5) 16,794 (3.9) 30,110 (6.7) 30,730 (6.7)
Families living in 5,786 (2.9) 7,913 (3.8) 7,753 (3.7) 7,895 (3.7) Poverty poverty Status Families living in 4,277 (4.4) 5,875 (5.8) 5,701 (5.7) 5,797 (5.7) poverty with children
Renter-occupied 75,865 (26.5) 82,749 (26.9) 84,104 (27.0) 86,149 (27.1) Housing Unit Type Owner-occupied 210,233 (73.5) 225,001 (73.1) 227,789 (73.0) 232,023 (72.9) Commute to 60 min. or more 29,033 (7.9) 34,457 (8.9) 37,050 (9.2) 37,791 (9.2) Work Median Household Income $61,538 $77,987 $76,825 $84,513
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
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Pennsylvania
Table 23. Socio-Demographic Indicators, U.S. Census
2000 2010 2013 2018 Total Population 12,281,026 12,702,379 12,785,546 12,910,005 Freq. % Freq. % Freq. % Freq. %
0-17 2,922,256 (23.8) 2,792,155 (22.0) 2,760,909 (21.6) 2,735,591 (21.2)
18-44 4,602,793 (37.5) 4,388,169 (34.5) 4,360,018 (34.1) 4,329,955 (33.5) Age 45-64 2,836,833 (23.1) 3,562,748 (28.0) 3,572,415 (27.9) 3,485,718 (27.0)
65+ 1,919,144 (15.6) 1,959,307 (15.4) 2,092,204 (16.4) 2,358,741 (18.3)
Male 5,929,727 (48.3) 6,190,363 (48.7) 6,233,014 (48.8) 6,296,695 (48.8) Gender Female 6,351,299 (51.7) 6,512,016 (51.3) 6,552,532 (51.2) 6,613,310 (51.2)
White 10,484,203 (84.4) 10,094,652 (79.5) 10,010,316 (78.3) 9,886,505 (76.6)
Black 1,224,612 (9.9) 1,327,091 (10.4) 1,363,150 (10.7) 1,416,944 (11.0)
Race/Ethnicity* Asian 219,813 (1.8) 346,288 (2.7) 377,857 (3.0) 423,710 (3.3)
Other 93,350 (0.8) 214,688 (1.7) 233,021 (1.8) 260,790 (2.0)
Latino 394,095 (3.2) 719,660 (5.7) 801,202 (6.3) 922,056 (7.1)
English N/A N/A 10,772,932 (89.9) 10,833,087 (89.9) 10,922,744 (89.9)
Language Spanish N/A N/A 515,279 (4.3) 508,744 (4.2) 512,994 (4.2) Spoken at Asian N/A N/A 203,715 (1.7) 205,074 (1.7) 206,626 (1.7) Home Language
Other N/A N/A 491,312 (4.1) 498,532 (4.1) 502,797 (4.1)
*White, Black, Asian and Other races exclude Latinos. N/A = not available due to a change in question wording. Source: Nielsen-Claritas Pop-Facts Database and 2000, 2010 U.S. Census.
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Table 24. Socio-Economic Indicators, U.S. Census
2000 2010 2013 2018
Total Population 12,281,026 12,702,379 12,785,546 12,910,005 Freq. % Freq. % Freq. % Freq. %
Less than HS 1,494,731 (18.1) 1,003,960 (11.6) 1,032,950 (11.8) 1,052,892 (11.8)
Education HS graduate 4,922,960 (59.6) 5,314,065 (61.4) 5,353,792 (61.3) 5,457,313 (61.3)
College or more 1,846,734 (22.3) 2,336,804 (27.0) 2,347,391 (26.9) 2,392,861 (26.9)
Employed 5,653,298 (94.4) 5,842,995 (90.4) 5,964,251 (91.1) 6,042,982 (91.1) Employment Unemployed 338,413 (5.6) 620,495 (9.6) 581,125 (8.9) 588,741 (8.9)
Families living in 254,108 (7.9) 297,387 (9.3) 298,155 (9.1) 301,570 (9.1) Poverty poverty Status Families living in 191,818 (12.3) 211,119 (15.9) 228,177 (15.3) 230,672 (15.3) poverty with children
Renter-occupied 1,370,694 (28.7) 1,527,182 (30.4) 1,543,211 (30.5) 1,566,008 (30.6) Housing Unit Type Owner-occupied 3,406,307 (71.3) 3,491,722 (69.6) 3,517,143 (69.5) 3,555,242 (69.4) Commute to 60 min. or more 408,090 (7.6) 460,195 (8.1) 479,184 (8.4) 485,738 (8.4) Work Median Household Income $41,440 $49,288 $51,142 $53,619
Source: Nielsen-Claritas Pop-Facts Database and 2010 U.S. Census.
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APPENDIX C: VITAL STATISTICS TABLES
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Table 1. Average Annualized Rates of Births and Birth Outcomes for Tri-County Area Women and for Women in Adjacent Counties, 2007-2010 Tri-County Berks Chester Montgomery Pennsylvania Area County County County
Rate Rate Rate Rate Rate (Number) (Number) (Number) (Number) (Number) Births per 1,000 live 64.0 62.1 58.1 60.2 57.4 births to women 15-44 (2,762) (4,936) (5,505) (9,117) (141,196) years old Births per 1,000 live 2.7 8.6 2.8 2.8 6.3 births to women 10-17 (34) (188) (77) (115) (4,062) years old Low Birth Weight Births 66.5 79.2 66.1 71.4 82.7 (<2,500 grams) per 1,000 (184) (392) (365) (654) (11,718) live births Percentage of women 21.5 30.7 26.6 26.7 29.8 with late or no prenatal (589) (1,479) (1,450) (2,343) (40,611) care 4.0 7.7 4.7 4.8 7.1 Infant mortality per (11) (38) (26) (44) (999) 1,000 live births Sources: Pennsylvania Department of Health, Bureau of Health Statistics and Research and Nielsen-Claritas Pop- Facts Database. Calculations prepared by PHMC.
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Table 2. Average Annualized Rates of Births and Birth Outcomes for Tri-County Area Women by Area, 2007-2010 Daniel Perkiomen Owen J. Tri-County Pottstown Pottsgrove Spring- Boyertown Boone Valley Roberts Area Borough Area Ford Area Area Area Area Area Rate Rate Rate Rate Rate Rate Rate Rate (Number) (Number) (Number) (Number) (Number) (Number) (Number) (Number) Births per 1,000 live 64.0 86.9 67.9 62.7 63.1 64.9 54.5 57.0 births to (2,762) (408) (284) (250) (584) (466) (449) (321) women 15- 44 years old Births per 1,000 live births to 2.7 11.7 * * * * * * women 10- (34) (12) 17 years old Low Birth Weight Births 66.5 73.2 57.1 56.9 74.1 61.0 73.9 57.4 (<2,500 (184) (30) (16) (14) (44) (29) (33) (19) grams) per 1,000 live births Percentage of women 21.5 34.1 22.7 19.0 18.2 17.8 19.7 20.5 with late or (589) (138) (64) (47) (106) (82) (87) (66) no prenatal care Infant mortality 4.0 * * * * * * * per 1,000 (11) live births Sources: Pennsylvania Department of Health, Bureau of Health Statistics and Research and Nielsen-Claritas Pop-Facts Database. Calculations prepared by PHMC. Note: * Not Displayed. Rates are not calculated and displayed when the count is less than 10.
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Table 3. Average Annualized Age-Adjusted Mortality Rates for Selected Major Causes of Death for Tri-County Area and Adjacent County Residents, 2007-2010 Tri-County Berks Chester Montgomery Pennsylvania Area County County County Rate1 Rate Rate Rate Rate (Number)2 (Number) (Number) (Number) (Number) 720.9 712.1 645.3 671.9 763.6 All Causes (1,632) (3,503) (3,346) (6,906) (122,469) 114.4 113.8 117.6 105.2 128.1 Coronary Heart Disease (262) (572) (617) (1,126) (21,222) Cerebrovascular 44.1 51.3 34.3 39.9 40.0 Disease (99) (264) (177) (428) (6,679) 165.8 167.7 167.1 165.6 179.9 All Cancers (377) (808) (869) (1,636) (28,389) 45.3 42.6 43.5 42.3 49.1 Lung Cancer (103) (205) (225) (414) (7,715) 19.5 23.1 21.8 21.6 23.4 Female Breast Cancer3 (26) (63) (65) (119) (2,072) 17.0 18.1 20.1 22.6 22.1 Prostate Cancer4 (15) (35) (41) (90) (1,386) 14.7 15.5 17.2 14.6 17.2 Colorectal Cancer (32) (74) (89) (146) (2,731) 22.2 14.1 11.6 13.5 14.8 Pneumonia/Influenza (50) (74) (61) (147) (2,480) 17.8 17.9 10.5 12.5 20.3 Diabetes Mellitus (41) (88) (56) (126) (3,245) 35.6 29.3 24.2 30.0 36.5 Accidents/Drugs (78) (130) (120) (268) (5,003) Motor Vehicle 53.3 55.6 38.1 46.2 57.6 Accidents (118) (240) (191) (407) (7,806) 11.0 11.6 9.7 10.8 11.3 Suicide (25) (49) (49) (91) (1,488) Sources: Pennsylvania Department of Health, Bureau of Health Statistics and Research and Nielsen- Claritas Pop-Facts Database. Calculations prepared by PHMC. 1Age-adjusted rates are computed by the direct method using the 2000 U.S. standard million population. Rates are per 100,000 persons based on an interpolation between U.S. Census 2000 and 2010 population figures. 2The number of deaths is an annual average of deaths occurring to PA residents between 2007 and 2010. 3Age-adjusted rates were calculated using females rather than all persons as the denominator 4 Age-adjusted rates were calculated using males rather than all persons as the denominator.
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Table 4. Average Annualized Age-Adjusted Mortality Rates for Top Five Causes of Death for Tri-County Area Residents by Area, 2007-2010 Daniel Owen J. Tri-County Pottstown Pottsgrove Spring- Perkiomen Boyertown Boone Roberts Area Borough Area Ford Area Valley Area Area Area Area Rate1 Rate Rate Rate Rate Rate Rate Rate (Number)2 (Number) (Number) (Number) (Number) (Number) (Number) (Number) 720.9 1,075.5 646.0 646.9 747.5 673.2 682.3 656.8 All Causes (1,632) (271) (144) (133) (314) (180) (358) (231)
165.8 231.1 153.6 161.6 174.1 152.8 156.8 148.8 All Cancers (377) (58) (34) (33) (53) (44) (83) (53)
Coronary Heart 114.4 144.4 122.0 103.0 119.1 111.3 110.1 103.1 Disease (262) (38) (28) (22) (51) (29) (59) (37)
Motor Vehicle 53.3 99.4 67.5 44.5 41.4 56.9 43.9 * Accidents (118) (23) (14) (19) (13) (27) (14)
45.3 65.5 47.7 46.4 42.8 43.7 36.3 Lung Cancer * (103) (16) (11) (20) (12) (23) (13)
Cerebrovascular 44.1 66.8 46.7 56.4 42.6 32.4 * * Disease (99) (17) (19) (14) (23) (12) Sources: Pennsylvania Department of Health, Bureau of Health Statistics and Research and Nielsen-Claritas Pop-Facts Database. Calculations prepared by PHMC. 1Age-adjusted rates are computed by the direct method using the 2000 U.S. standard million population. Rates are per 100,000 persons based on an interpolation between U.S. Census 2000 and 2010 population figures. 2The number of deaths is an annual average of deaths occurring to PA residents between 2007 and 2010. Note: * Not Displayed. Rates are not calculated and displayed when the count is less than 10.
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Table 5. Reported Incidence and Average Annual Rate (per 100,000 persons) for Selected Notifiable Diseases by County, 2012 Montgomery Berks County ChesterCounty Pennsylvania County Rate Rate Rate Rate (Number) (Number) (Number) (Number) 3.7 5.1 11.9 5.5 Pertussis (35) (76) (280) (2,089) 16.5 15.1 11.9 14.6 Varicella (202) (225) (280) (5,494) 23.0 158.3 57.1 35.8 Lyme Disease (281) (2,357) (1,347) (13,518) 8.0 2.4 4.9 6.5 AIDS (98) (35) (116) (2,455) 1.4 1.7 2.7 2.3 Tuberculosis (17) (26) (64) (861) 11.5 7.3 20.8 13.6 Hepatitis B, Chronic (140) (109) (492) (5,137) 299.3 170.3 183.8 351.8 Chlamydia (3,658) (2,536) (4,337) (132,819) 39.9 29.7 33.9 90.3 Gonorrhea (488) (442) (800) (34,092) Syphilis, Primary and 1.0 2.0 2.6 * Secondary (12) (47) (982) *Crude rates based on less than 10 events are considered statistically unreliable and are not displayed. Notifiable disease rates are calculated per 100,000 population. Source: Pennsylvania Department of Health, Bureau of Health Statistics and Research, County Health Profiles.
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APPENDIX D: HOUSEHOLD HEALTH SURVEY TABLES
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Table 1. Health Status of Tri-County Area Adults by Socioeconomic and Demographic Characteristics
Tri-County Age Insurance Status Poverty Status* Area 18-29 30-44 45-64 65+ Uninsured Insured Poor Non-poor N N N N (%) (%) (%) (%) 153,100 22,800 36,400 68,500 25,500 8,900 148,200 24,000 132,800 Excellent/Very Good/Good (86.1) (93.9) (90.0) (84.6) (78.7) (78.1) (86.6) (65.8) (91.2) Health Status 24,800 1,500 4,000 12,400 6,900 2,500 22,900 12,500 12,800 Fair/Poor (13.9) (6.1) (10.0) (15.4) (21.3) (21.9) (13.4) (34.2) (8.8) 29,400 5,500 6,700 14,400 2,800 3,700 26,000 9,200 20,400 Diagnosed with mental health condition (16.5) (22.9) (16.6) (17.7) (8.8) (31.9) (15.3) (25.3) (14.1) Sought professional help for a mental or emotional 16,600 4,000 4,500 6,800 1,300 2,200 14,900 6,700 10,400 problem (9.4) (16.6) (11.1) (8.4) (3.9) (19.5) (8.7) (18.5) (7.1) 18,200 1,900 4,500 9,900 2,000 1,700 16,700 6,900 11,400 Mental Health Receiving treatment for mental health condition (62.1) (33.6) (66.7) (69.4) (70.3) (46.0) (64.0) (75.2) (55.8) 41,200 5,500 10,700 21,000 4,200 6,200 35,700 9,900 41,600 High level of stress (23.4) (22.7) (26.4) (25.9) (13.3) (54.4) (21.0) (27.1) (28.8) 13,100 1,100 3,900 6,900 1,200 2,900 10,400 5,100 8,100 Currently in recovery (7.4) (4.7) (9.6) (8.5) (3.9) (25.1) (6.1) (13.9) (5.6) 60,600 6,200 14,900 27,400 12,000 2,700 59,400 10,900 50,800 Overweight (34.3) (25.5) (37.7) (34.0) (37.7) (23.5) (35.1) (30.5) (35.2) Body Mass Index 53,200 3,200 11,500 28,100 19,400 2,800 51,300 13,200 40,900 Obese (30.2) (13.4) (29.1) (34.8) (32.4) (24.9) (30.3) (36.9) (28.3) 13,700 900 6,000 6,800 700 13,800 3,400 11,000 Cancer (7.7) --- (2.3) (7.4) (21.1) (6.0) (8.1) (9.5) (7.6) 28,300 5,400 8,200 11,400 3,300 3,000 25,900 7,500 21,400 Asthma (15.9) (22.4) (20.3) (14.0) (10.3) (26.5) (15.1) (20.6) (14.7) 19,400 20 1,900 10,200 7,300 2,100 17,600 6,700 13,000 Diabetes (10.9) (0.1) (4.6) (12.7) (22.5) (18.4) (10.3) (18.3) (8.9) Chronic Health 52,400 1,700 7,200 27,300 16,200 4,000 49,800 13,400 40,300 High blood pressure Conditions (29.4) (7.0) (17.8) (33.7) (50.0) (34.9) (29.1) (36.8) (27.7) 42,100 1,100 3,900 21,300 15,800 3,100 40,400 12,100 31,300 Arthritis (23.7) (4.6) (9.6) (26.3) (49.3) (27.2) (23.6) (33.3) (21.5) 17,300 600 1,700 6,7800 8,300 1,300 16,600 6,600 11,200 Heart disease (9.7) (2.4) (4.3) (8.3) (25.5) (11.3) (9.7) (18.1) (7.7) 41,600 2,500 6,300 23,800 8,900 4,600 37,800 14,500 27,800 Pain lasting six months or more (23.4) (10.5) (15.7) (29.5) (27.5) (40.0) (22.1) (39.8) (19.1) Note: ---- equals insufficient cases for analysis (n<30). * Poverty is defined as income below 200% of the Federal Poverty Level. High level of stress is defined as seven or higher on a 10 point scale. Overweight is defined as having a BMI of 25-29 and obese is defined as having a BMI of 30 or greater. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 2. Selected Health Status and Access to Care Indicators for Tri-County Area Children by Socioeconomic and Demographic Characteristics Age Poverty Status* Tri-County Area 0-5 6-11 12-17 Poor Non-poor N N N (%) (%) (%) 54,300 16,100 17,200 20,000 8,100 45,300 Excellent/Very Good/Good (97.7) (97.0) (98.4) (97.6) (94.4) (98.3) Health Status 1,300 500 300 500 483 800 Fair/Poor (2.3) (3.0) (1.6) (2.4) (5.6) (1.7) 6,900 3,900 3,000 1,700 5,200 Overweight N/A (18.9) (23.6) (15.1) (28.7) (17.0) Body Mass Index 5,700 2,900 2,800 1,300 4,400 Obese N/A (15.6) (17.5) (14.1) (21.8) (14.4) 7,400 2,000 2,200 3,200 2,500 5,000 Ever diagnosed with asthma (13.6) (12.2) (12.8) (15.4) (28.2) (10.9) 1,700 600 400 800 500 1,200 No regular source of care (3.1) (3.4) (2.1) (3.7) (6.2) (2.5) 1,900 300 500 1,100 100 1,800 Family or friends (3.6) (1.8) (3.2) (5.4) (1.2) (4.1) Source of information on Physician or other health 47,300 14,400 15,500 17,400 8,500 39,000 children’s health care professional (88.9) (89.1) (91.4) (86.5) (98.4) (87.1) 4,000 1,500 900 1,600 40 4,000 Internet (7.5) (9.1) (5.4) (8.0) (0.4) (8.9) 9,800 7,800 300 1,700 1,500 8,300 Did not visit dentist in the past year (17.9) (46.9) (1.8) (8.3) (16.9) (18.1) Notes: N/A = not applicable. * Poverty is defined as income below 200% of the Federal Poverty Level. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 3. Health Insurance and Source of Care of Tri-County Area Adults by Socioeconomic and Demographic Characteristics
Age Insurance Status Poverty Status* Tri-County Area 18-29 30-44 45-64 65+ Uninsured Insured Poor Non-poor N N N N (%) (%) (%) (%) 11,300 1,700 3,400 6,100 11,300 5,800 5,400 Uninsured (18-64) N/A N/A (7.8) (7.2) (8.4) (7.6) (100.0) (22.8) (4.3) 24,800 4,500 6,200 10,500 3,600 10,300 14,600 9,100 15,900 No prescription drug coverage (14.1) (19.2) (15.5) (13.1) (11.3) (92.6) (8.7) (25.3) (11.0) 17,500 3,700 5,300 7,000 1,500 4,400 13,300 4,700 12,700 No regular source of care (9.8) (15.4) (13.0) (8.6) (4.7) (37.5) (7.8) (12.8) (8.7) 51,300 9,700 12,000 19,800 10,000 8,800 43,100 16,600 35,200 Did not visit dentist in past year (28.9) (39.9) (29.6) (24.5) (30.8) (77.2) (25.2) (45.8) (24.2) Notes: N/A = not applicable. * Poverty is defined as income below 200% of the Federal Poverty Level. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 4. Cost Barriers to Care for Tri-County Area Adults by Socioeconomic and Demographic Characteristics
Age Insurance Status Poverty Status* Tri-County Area 18-29 30-44 45-64 65+ Uninsured Insured Poor Non-poor N N N N In the past year DID NOT… (%) (%) (%) (%) 25,300 3,900 6,900 13,400 1,000 6,000 19,500 9,400 16,100 Seek health care due to cost (14.2) (16.1) (17.1) (16.6) (3.2) (52.3) (11.4) (25.7) (11.0) Seek health care due to transportation 6,800 1,300 1,900 2,500 1,000 1,000 5,900 4,900 2,000 problems (3.8) (5.5) (4.7) (3.1) (3.1) (8.5) (3.4) (13.3) (1.4) 27,200 3,500 9,200 12,100 2,400 4,300 24,000 11,300 16,900 Fill prescription due to cost (15.3) (14.5) (22.8) (15.0) (7.3) (37.3) (14.1) (31.3) (11.6)
Last year
Found it difficult or very difficult to pay 74,100 7,200 19,600 36,500 10,800 8,800 66,900 26,300 49,100 housing costs (42.6) (31.8) (48.7) (45.5) (34.6) (77.3) (40.0) (72.5) (34.6) * Poverty is defined as income below 200% of the Federal Poverty Level. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 5. Nutrition of Tri-County Area Adults by Socioeconomic and Demographic Characteristics
Age Insurance Status Poverty Status* Tri-County Area 18-29 30-44 45-64 65+ Uninsured Insured Poor Non-poor N N N N (%) (%) (%) (%) 12,600 1,600 2,600 5,500 2,800 1,400 11,500 2,100 10,800 Family or friends (7.4) (7.0) (6.7) (7.1) (9.7) (13.1) (7.0) (6.3) (7.7) 44,700 5,100 9,800 20,200 9,700 1,700 43,500 13,100 32,100 Physician or health care professional (26.3) (21.7) (24.9) (25.7) (33.7) (15.9) (26.6) (39.5) (22.8) Primary sources of information on 12,500 900 400 6,000 5,300 1,100 12,400 1,800 11,700 Written material nutrition (7.4) (3.7) (0.9) (7.6) (18.5) (10.1) (7.6) (5.4) (8.3) 69,000 13,100 22,500 30,200 3,100 4,800 66,100 10,600 60,100 Internet (40.6) (56.0) (57.2) (38.5) (10.9) (45.3) (40.4) (31.8) (42.7) 15,400 700 1,600 8,000 5,100 800 14,700 2,700 12,800 Don't look (9.0) (2.8) (4.1) (10.2) (17.8) (7.1) (9.0) (8.1) (9.1) 122,300 16,900 25,800 56,300 23,400 8,300 116,600 25,300 99,200 0-3 servings Number of fruits and vegetables (69.8) (70.3) (64.7) (70.3) (74.8) (75.5) (69.1) (72.3) (68.8) consumed in typical day 52,900 7,100 14,100 23,800 7,900 2,700 52,100 9,700 45,000 4 or more servings (30.2) (29.7) (3.3) (29.7) (25.2) (24.5) (30.9) (27.7) (31.2) 8,800 1,300 1,700 3,200 2,600 600 8,300 4,100 4,800 Difficult or very difficult to find fruits or vegetables in their neighborhood (4.9) (5.4) (4.3) (3.9) (8.0) (5.1) (4.9) (11.3) (3.3) 17,200 3,400 3,500 8,400 2,000 2,500 15,000 5,500 12,000 Overall quality of groceries in neighborhood stores is fair or poor (9.8) (14.0) (8.7) (10.4) (6.5) (22.4) (8.9) (15.3) (8.3) 19,400 2,800 5,500 9,800 1,400 3,400 16,100 11,900 7,500 Cut meal size or skip a meal due to cost (11.0) (11.4) (13.6) (12.2) (4.3) (30.0) (9.4) (32.7) (5.2) 98,000 8,000 21,600 45,800 22,500 5,300 95,600 20,800 79,700 None How many times eaten at fast food (55.1) (33.2) (53.5) (56.7) (69.4) (46.1) (56.0) (57.0) (54.8) restaurant in past week 79,900 16,200 18,800 34,900 9,900 6,200 75,300 15,700 65,800 1 or more times (44.9) (66.8) (46.5) (43.3) (30.6) (53.9) (44.0) (43.0) (45.2) 66,700 11,500 15,300 28,600 11,300 4,700 63,500 14,900 53,400 Menu labeling did not influence food choice 63.3% (59.5) (57.8) (64.9) (73.3) (73.8) (62.6) (73.7) (60.8) 99,200 10,900 28,400 45,700 14,200 5,100 97,000 17,600 84,100 Dieted to lose weight in the past year (56.2) (45.2) (70.3) (57.0) (44.7) (46.3) (57.0) (48.3) (58.4) * Poverty is defined as income below 200% of the Federal Poverty Level. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 6. Physical Activity of Tri-County Area Adults by Socioeconomic and Demographic Characteristics
Age Insurance Status Poverty Status* Tri-County Area 18-29 30-44 45-64 65+ Uninsured Insured Poor Non-poor
N N N (%) (%) (%) 30,700 1,400 3,900 16,200 9,100 1,900 29,100 8,900 22,000 None (17.2) (5.9) (9.5) (20.0) (28.4) (16.5) (17.1) (24.6) (15.1) 45,200 6,100 11,100 20,800 7,200 2,400 44,900 8,500 38,500 Number of times exercised in past month 1-2 days per week (25.5) (25.1) (27.5) (25.8) (22.4) (20.9) (26.3) (23.5) (26.5) 101,800 16,700 25,400 43,800 15,800 7,200 96,700 18,900 84,900 3 or more days per week (57.3) (69.0) (62.9) (54.2) (49.2) (62.6) (56.6) (51.9) (58.4) 73,900 8,900 12,100 33,100 19,700 5,400 71,000 18,300 58,000 Watched television more than two hours per day (41.5) (36.9) (30.0) (40.9) (61.2) (46.8) (41.6) (50.3) (39.8) 3,300 9,400 5,700 14,000 3,300 4,000 29,100 4,000 28,800 Used computer more than two hours per day (10.3) (38.9) (14.2) (17.3) (10.3) (35.4) (17.0) (11.1) (19.8) 91,400 17,400 24,200 45,200 4,600 85,300 10,100 83,100 Did not participate in worksite wellness program (82.3) (96.9) (76.6) (80.0) (92.8) --- (80.7) (90.5) (81.1) 7,100 1,600 2,600 2,900 500 6,800 300 7,000 Commutes to work more than 60 minutes (7.1) (9.7) (8.9) (5.8) --- (7.1) (7.2) (3.1) (7.6) 95,700 15,800 27,600 48,000 4,300 7,200 90,800 9,400 88,600 Car, truck, or van (86.4) (88.3) (87.6) (85.1) (86.8) (91.0) (86.0) (84.2) (86.6) 1,000 200 400 500 100 900 200 800 Public transit --- (0.9) (0.9) (1.2) (0.8) (1.7) (0.8) (2.1) (0.7) Method of getting to work 2,900 700 500 1,700 400 2,500 300 2,600 Walking (2.6) (3.7) (1.6) (3.0) --- (4.8) (2.3) (2.4) (2.5) 700 100 100 400 100 700 700 Other --- (0.6) (0.4) (0.5) (0.7) (1.2) --- (0.6) (0.7) 39,000 4,400 6,000 17,900 10,700 3,800 35,600 11,100 28,300 Uncomfortable visiting neighborhood outdoor space or park during day (22.1) (18.1) (14.9) (22.2) (34.5) (33.1) (21.0) (30.9) (19.6) 11,600 2,200 3,800 4,000 1,600 1,300 10,700 4,800 7,300 Did not go somewhere during the day due to safety (6.5) (9.3) (9.3) (5.0) (5.0) (11.4) (6.3) (13.1) (5.0) 58,300 9,900 13,600 23,400 11,300 5,700 53,200 18,300 40,500 Low social capital in neighborhood (32.9) (41.4) (33.6) (29.0) (35.7) (49.7) (31.2) (50.2) (28.0) 95,400 15,600 21,900 42,600 15,400 7,600 89,400 18,200 78,600 Not active in a faith community (54.1) (64.8) (54.3) (52.9) (48.5) (66.1) (52.7) (50.2) (54.5) 106,400 12,900 17,400 49,900 26,300 7,400 101,100 27,100 81,400 Did not use public recreation facilities in the Tri-County Area (59.8) (53.4) (43.0) (61.6) (80.9) (64.8) (59.1) (74.2) (55.8) 131,300 19,200 33,300 58,600 20,200 9,300 124,600 27,600 106,300 Has not heard of the Tri-County Area Health & Wellness Foundation (74.5) (79.4) (82.3) (73.3) (63.9) (81.9) (73.7) (76.1) (73.8) * Poverty is defined as income below 200% of the Federal Poverty Level. --- equals insufficient cases for analysis (n < 30). Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 7. Nutrition and Physical Activity of Tri-County Area Children by Age and Poverty Status
Age Poverty Status* Tri-County Area 0-5 6-11 12-17 Poor Non-poor N N N (%) (%) (%) 31,300 4,300 11,700 15,300 5,500 25,800 0-3 Number of fruits and vegetables (68.0) (52.4) (66.6) (75.6) (73.7) (66.9) consumed in typical day 14,700 3,900 5,900 4,900 2,000 12,700 4+ (32.0) (47.6) (33.4) (24.4) (26.3) (33.1) 5,000 700 700 3,600 1,800 3,200 Drinks sugary beverage more than once a day (11.0) (4.9) (4.7) (21.4) (20.8) (8.7) 2,500 500 1,200 800 400 2,000 Family or friends (4.6) (2.8) (7.1) (4.0) (4.8) (4.6) Physician or other 32,200 12,300 10,100 9,900 7,300 25,000 health care (60.4) (74.1) (58.5) (50.5) (84.6) (55.8) professional Source of information on children’s 1,500 200 600 700 1,500 nutrition Books or pamphlets ---- (2.7) (1.5) (3.2) (3.3) (3.2) 12,800 3,000 4,300 5,500 400 12,300 Internet (24.0) (17.9) (25.0) (28.1) (5.0) (27.5) 1,200 100 1,100 30 1,200 Don't look ---- (2.2) (0.6) (5.6) (0.3) (2.6) 5,600 300 1,200 4,100 900 4,800 0-2 Number of times physically active in past (12.2) (3.2) (7.0) (20.2) (11.7) (12.3) week for 30 minutes or more 40,600 8,000 16,300 16,300 6,600 34,000 3 or more (87.8) (96.8) (79.8) (79.8) (88.3) (87.7) 14,400 1,100 4,300 9,000 2,900 11,500 Watched television more than two hours per day (31.3) (13.2) (24.6) (44.4) (39.7) (29.7) 8,200 200 1,200 6,800 1,400 6,800 Used computer more than two hours per day (17.8) (2.9) (6.7) (33.3) (18.3) (17.7) 8,000 8,000 1,400 6,600 Less than one hour per week in early childhood education setting N/A N/A (50.0) (50.0) (68.9) (47.2) Notes: ---- equals insufficient cases for analysis (n<30). N/A = not applicable * Poverty is defined as income below 200% of the Federal Poverty Level. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 8. Health Behaviors of Tri-County Area Adults by Socioeconomic and Demographic Characteristics
Tri-County Age Insurance Status Poverty Status* Area 18-29 30-44 45-64 65+ Uninsured Insured Poor Non-Poor N N N N (%) (%) (%) (%) 34,300 6,000 8,800 15,700 3,800 5,700 28,700 12,200 22,200 Smokes Cigarettes (19.3) (24.7) (21.8) (19.4) (11.8) (49.7) (16.8) (33.5) (15.3) Have tried quitting smoking in past year 20,300 4,500 6,300 7,600 1,900 4,000 16,300 8,500 11,900 (among smokers) (59.2) (74.6) (71.4) (48.6) (50.1) (70.9) (56.8) (69.6) (53.4) 20,500 3,700 3,500 10,600 2,700 4,100 16,400 7,500 13,100 Someone smokes inside the home (11.5) (15.3) (8.6) (13.1) (8.4) (37.2) (9.6) (20.5) (9.0) Consumed 5 or more drinks in past month 5,100 1,000 1,700 2,200 200 600 4,500 1,200 3,900 on five or more occasions (2.9) (4.3) (4.3) (2.7) (0.6) (4.9) (2.7) (3.2) (2.7) * Poverty is defined as income below 200% of the Federal Poverty Level. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County AreaHousehold Health Survey
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Table 9. Health Screenings for Tri-County Area Adults by Socioeconomic and Demographic Characteristics
Age Insurance Status Poverty Status* Tri-County Area 18-29 30-44 45-64 65+ Uninsured Insured Poor Non-poor N N N N (%) (%) (%) (%) Adults who did NOT receive: 16,600 3,700 5,200 6,700 1,000 3,900 12,900 3,300 13,200 Blood pressure test in the past year 9.4% 15.9% 12.8% 8.4% 3.1% 35.2% 7.6% 9.1% 9.2% Blood cholesterol test in the past 51,700 11,800 15,900 20,800 3,200 6,100 46,600 10,400 42,100 year 30.1% 57.3% 40.7% 26.1% 9.8% 54.9% 28.3% 29.7% 29.9% Colonoscopy in past year 70,500 44,600 25,900 3,900 67,700 17,100 54,500 N/A N/A (adults 50+) 83.3% 84.9% 80.7% 99.2% 82.3% 85.0% 82.4% Pap smear in the past year 40,100 5,800 5,400 18,400 10,500 3,200 38,200 11,600 29,800 (women 18+) 45.0% 51.9% 28.2% 43.7% 63.2% 75.1% 43.8% 55.5% 42.2% Mammogram in the past year 28,800 3,700 19,200 5,900 2,200 26,800 7,400 21,500 N/A (women 40+) 43.2% 46.2% 45.5% 35.6% 70.8% 41.5% 46.0% 41.8% PSA or rectal exam for prostate 15,300 12,800 2,500 1,200 14,300 3,000 12,400 N/A N/A cancer in past year (men 45+) 36.9% 46.6% 17.9% 80.9% 34.9% 45.7% 34.7% * Poverty is defined as income below 200% of the Federal Poverty Level.N/A = Not applicable. Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 10. Health Status of Tri-County Area Adults by Area Pottstown Pottsgrove Daniel Owen J. Spring-Ford Perkiomen Boyertown Tri-County Area Borough Area Boone Area Roberts Area Area Valley Area Area
N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) 157,100 13,600 13,900 12,800 28,300 29,400 27,000 32,100 Excellent/Very Good/Good (86.1) (79.6) (86.0) (81.4) (86.8) (81.6) (92.8) (89.7) Health Status 25,400 3,500 2,300 2,900 4,300 6,600 2,100 3,700 Fair/Poor (13.9) (20.4) (14.0) (18.6) (13.2) (18.4) (7.2) (10.3) Diagnosed with mental health 29,700 3,000 3,600 2,000 5,100 4,800 5,200 5,800 condition (16.3) (18.0) (22.4) (13.0) (15.7) (13.4) (17.9) (16.3) Sought professional help for a mental 17,100 2,000 1,200 1,800 3,700 3,500 1,500 3,500 or emotional problem (9.4) (11.5) (7.7) (11.4) (11.2) (9.6) (5.2) (9.9) Receiving treatment for mental health 18,300 1,500 2,500 1,600 3,200 3,000 3,200 3,300 Mental Health condition (61.8) (48.5) (69.1) (76.7) (63.5) (62.2) (61.7) (57.2) 41,900 5,300 4,600 3,800 7,800 6,500 6,800 7,100 High level of stress (23.2) (31.7) (28.4) (24.3) (24.0) (18.0) (23.6) (20.3) 13,200 1,800 1,800 1,300 2,400 2,300 1,800 1,900 Currently in recovery (7.3) (10.5) (11.1) (8.1) (7.2) (6.5) 6.3) (5.4) 62,000 5,900 5,400 4,900 11,700 13,000 9,500 11,700 Overweight (34.4) (35.5) (33.7) (32.0) (35.8) (36.3) (33.2) (32.8) Body Mass Index 54,100 5,400 6,000 5,500 7,100 11,500 8,100 10,500 Obese (30.0) (32.7) (37.6) (35.5) (21.8) (32.3) (28.4) (29.3) 14,500 1,300 1,000 1,700 3,400 2,100 1,700 3,300 Cancer (7.9) (7.4) (6.1) (10.6) (10.5) (5.8) (5.9) (9.3) 28,900 4,300 2,500 2,700 4,500 3,700 5,800 5,500 Asthma (15.9) (25.5) (15.6) (17.4) (13.6) (10.2) (19.8) (15.4) 19,700 1,500 1,600 1,900 2,500 4,600 2,500 5,000 Diabetes (10.8) (8.8) (10.0) (12.1) (7.6) (12.8) (8.8) (14.0) 53,800 5,100 4,800 3,800 9,600 10,000 9,300 11,200 Chronic Health High blood pressure Conditions (29.4) (29.9) (29.8) (24.4) (29.2) (27.7) (31.9) (31.2) 43,500 4,000 4,900 3,400 7,800 7,600 6,300 9,500 Arthritis (23.9) (23.8) (30.0) (21.6) (23.8) (21.0) (21.5) (26.7) 17,900 2,000 1,400 1,900 2,400 4,300 2,900 3,000 Heart disease (9.8) (11.7) (8.9) (11.8) (7.4) (11.9) (10.0) (8.3) 42,400 4,200 3,200 3,400 8,100 7,900 7,200 8,500 Pain lasting six months or more (23.3) (24.5) (19.9) (21.3) (24.7) (22.0) (25.0) (23.6)
Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 11. Selected Health Status and Access to Care Indicators of Tri-County Area Children by Area Daniel Owen J. Spring- Tri-County Pottstown Pottsgrove Perkiomen Boyertown Boone Roberts Ford Area Borough Area Valley Area Area Area Area Area N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) Excellent/Very 53,400 4,400 5,100 __ 9,300 11,500 8,300 9,800 Good/Good (97.7) (94.6) (99.3) (97.7) (97.0) (98.0) (97.6) Health Status 1,270 200 30 200 400 200 200 Fair/Poor --- (2.3) (5.4) (0.7) (2.3) (3.0) (2.0) (2.4) 6,900 800 400 800 700 1,600 1,500 1,100 Overweight Body Mass (18.9) (29.3) (11.6) (22.6) (11.7) (19.0) (25.2) (17.2) Index 5,700 700 700 700 1,300 800 600 1,000 Obese (15.6) (26.5) (20.4) (18.2) (21.0) (8.8) (10.0) (16.2) 7,500 1,200 900 800 900 1,500 700 1,300 Ever diagnosed with asthma (13.7) (26.5) (18.3) (16.4) (9.7) (12.8) (8.4) (13.3) 1,700 500 100 300 100 700 No regular source of care ------(3.1) (10.9) (2.0) (2.9) (1.0) (7.3) Family or 1,900 200 100 100 300 300 900 --- friends (3.6) (3.5) (2.0) (1.4) (2.8) (4.2) (8.8) Source of Physician or information on other health 47,500 4,100 4,500 4,800 8,700 10,000 7,000 8,300 children’s care (88.9) (88.7) (88.0) (95.1) (91.1) (93.7) (83.9) (83.1) health professional 4,000 400 500 200 700 400 1,000 800 Internet (7.5) (7.8) (10.0) (4.9) (7.5) (3.5) (11.9) (8.1) Did not visit dentist in the past 9,800 1,100 600 400 1,900 2,400 1,100 2,400 year (17.9) (23.0) (12.5) (8.4) (19.8) (20.1) (12.3) (23.6) Note: ---- equals insufficient data for analysis (n<30). Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County AreaHousehold Health Survey
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Table 12. Health Insurance and Source of Care of Tri-County Area Adults by Area Owen J. Spring-Ford Perkiomen Pottstown Pottsgrove Daniel Boyertown Tri-County Area Roberts Area Valley Area Borough Area Boone Area Area Area N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) 11,400 2,000 600 1,000 2,400 1,100 1,800 2,600 Uninsured (18-64) (7.6) (14.4) (4.7) (7.9) (9.0) (3.5) (7.1) (9.1) No prescription 24,900 3,400 1,400 2,300 5,500 4,900 2,600 5,000 drug coverage (13.8) (20.4) (8.4) (14.5) (16.8) (13.7) (9.1) (14.2) No regular source 17,600 2,900 2,500 1,700 2,500 1,600 1,500 4,900 of care (9.7) (17.0) (15.7) (10.9) (7.7) (4.4) (5.1) (13.8) Did not visit 51,900 6,600 4,900 4,700 7,800 10,700 5,700 11,400 dentist in past (28.5) (39.1) (30.9) (30.1) (23.8) (29.8) (19.7) (31.8) year Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County AreaHousehold Health Survey
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Table 13. Cost Barriers to Care for Tri-County Area Adults by Area Tri-County Pottstown Pottsgrove Daniel Boone Owen J. Spring-Ford Perkiomen Boyertown Area Borough Area Area Roberts Area Area Valley Area Area N N N N N N N N In the past year DID NOT… (%) (%) (%) (%) (%) (%) (%) (%) 25,500 3,300 1,800 2,300 5,400 5,600 3,800 3,400 Seek health care due to cost (14.0) (19.2) (11.1) (14.3) (16.4) (15.5) (13.1) (9.5) Seek health care due to 6,800 1,200 800 300 400 2,200 1,300 700 transportation problems (3.7) (7.0) (5.1) (1.8) (1.2) (6.0) (4.4) (1.9) 28,300 3,700 2,100 3,500 4,700 7,000 3,200 4,000 Fill prescription due to cost (15.5) (21.9) (13.0) (22.3) (14.5) (19.5) (11.1) (11.1)
Last year
Found it difficult or very difficult to 75,700 9,900 8,400 6,800 10,600 15,100 11,000 14,000 pay housing costs (42.4) (58.4) (53.6) (44.3) (33.3) (42.1) (38.6) (40.5)
Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County AreaHousehold Health Survey
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Table 14. Nutrition of Tri-County Area Adults by Area Pottstown Pottsgrove Daniel Boone Owen J. Spring-Ford Perkiomen Boyertown Tri-County Area Borough Area Area Roberts Area Area Valley Area Area
N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) 12,900 900 600 1,000 4,100 2,300 1,900 2,100 Family or friends (7.4) (5.3) (4.1) (6.4) (12.9) (6.4) (6.9) (6.5) Physician or other 45,200 5,500 5,000 4,900 6,100 9,700 5,300 8,800 health care (26.0) (33.9) (32.7) (32.3) (19.3) (27.8) (18.8) (26.6) Primary sources of professional information on 13,500 1,100 1,600 1,100 2,200 1,900 2,500 3,100 Written material nutrition (7.8) (6.6) (10.4) (7.3) (7.0) (5.6) (8.9) (9.4) 70,900 5,300 6,500 5,100 12,400 14,900 15,200 4,400 Internet (40.7) (32.7) (42.5) (33.7) (39.3) (42.5) (54.1) (35.1) 15,500 1,100 700 1,000 4,100 2,700 1,500 4,400 Don’t look (8.9) (6.9) (4.7) (6.3) (13.0) (7.6) (5.5) (13.3) 124,800 13,300 10,100 11,300 22,200 24,600 18,600 24,800 Number of fruits and 0-3 servings (69.5) (80.6) (62.7) (74.1) (68.2) (69.1) (64.1) (71.6) vegetables consumed 54,700 3,200 6,000 3,900 10,300 11,000 10,400 9,900 in typical day 4 or more servings (30.5) (19.4) (37.3) (25.8) (31.8) (30.9) (35.9) (28.4)
Difficult or very difficult to find fruits or 8,900 1,400 900 2,200 1,100 1,100 1,000 1,200 vegetables in their neighborhood (4.9) (8.2) (5.6) (14.0) (3.2) (3.1) (3.5) (3.5)
Overall quality of groceries in neighborhood 17,500 3,000 1,500 2,000 2,500 2,500 1,700 4,300 stores is fair or poor (9.7) (17.7) (9.9) (12.8) (7.7) (7.0) (5.8) (12.2)
19,500 2,800 1,300 1,800 3,100 5,200 2,400 2,900 Cut meal size or skip a meal due to cost (10.7) (16.3) (8.2) (11.3) (9.6) (14.5) (8.4) (8.0) 100,900 8,400 9,500 7,400 19,700 21,900 14,600 19,400 How many times eaten None (55.3) (49.1) (58.8) (46.9) (60.4) (60.8) (50.2) (54.5) at fast food restaurant 81,500 8,600 6,700 8,400 13,000 14,100 14,500 16,200 in past week 1 or more times (44.7) (50.9) (41.2) (53.1) (39.6) (39.2) (49.8) (45.5) 68,300 8,000 6,800 7,300 9,200 11,100 9,000 16,800 Menu labeling did not influence food choice (63.3) (71.1) (62.8) (62.4) (59.7) (57.8) (52.2) (75.7) 102,100 9,000 9,900 9,200 18,300 22,700 15,300 17,600 Dieted to lose weight in the past year (56.4) (53.3) (61.1) (58.8) (56.2) (63.0) (52.7) (51.0) Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 15. Nutrition and Physical Activity of Tri-County Area Children by Area
Pottstown Pottsgrove Daniel Owen J. Spring-Ford Perkiomen Boyertown Tri-County Area Borough Area Boone Area Roberts Area Area Valley Area Area
N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) 31,300 2,300 2,700 2,600 5,700 6,900 4,600 6,400 0-3 (55.8) (69.8) (72.8) (61.5) Number of fruits and vegetables (68.0) (64.8) (65.1) (76.5) consumed in typical day 14,700 1,300 1,500 2,100 2,500 2,600 2,900 1,900 4+ (32.0) (35.2) (34.9) (44.2) (30.2) (27.2) (38.5) (23.5) 5,000 700 700 900 500 700 400 1,200 Drinks sugary beverage more than once a day (11.0) (17.2) (13.8) (18.1) (6.5) (7.4) (6.2) (13.3) 2,500 200 300 200 900 500 200 300 Family or friends (4.6) (3.4) (5.5) (4.2) (9.4) (3.9) (2.6) (3.0) Physician or 32,300 3,500 2,900 3,100 5,600 6,000 4,900 6,400 other health care (60.5) (76.9) (61.8) (61.0) (61.4) (51.2) (57.3) (64.7) Source of information on professional children’s nutrition Books or 1,500 30 100 100 100 400 500 20 pamphlets (2.7) (0.6) (2.6) (2.0) (1.1) (3.5) (5.5) (2.2) 12,800 500 900 1,300 1,800 3,500 2,500 2,200 Internet (23.9) (10.4) (20.1) (25.1) (20.1) (30.1) (29.4) (22.7) 500 900 1,400 900 5,600 400 700 900 Number of times physically 0-2 (10.2) (10.5) (14.7) (12.2) (12.2) (12.0) (15.8) (10.5) active in past week for 30 minutes or more 40,600 3,300 3,500 4,300 7,300 8,100 6,500 7,600 3 or more (87.8) (88.0) (84.2) (89.8) (89.5) (85.3) (87.8) (89.5) 14,400 1,100 2,200 1,500 1,900 2,400 2,400 3,000 Watched television more than two hours per day (31.3) (29.2) (54.2) (31.1) (23.5) (24.9) (31.8) (35.7) 8,200 600 1,400 1,100 700 2,000 1,200 1,300 Used computer more than two hours per day (17.8) (15.1) (33.7) (22.5) (9.0) (21.5) (15.5) (15.0) Less than one hour per week in early childhood 8,000 1,400 1,300 500 800 1,600 1,300 1,100 education setting (50.0) (80.9) (74.0) (41.8) (26.4) (49.8) (54.2) (42.3)
Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 16. Physical Activity of Tri-County Area Adults by Area Pottstown Pottsgrove Daniel Boone Owen J. Spring-Ford Perkiomen Boyertown Tri-County Area Borough Area Area Roberts Area Area Valley Area Area
N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) 31,000 2,500 3,500 3,500 5,800 4,600 4,800 6,300 None (17.0) (14.7) (21.8) (22.3) (17.8) (12.8) (16.6) (17.5) Number of times exercised in 47,300 5,100 2,800 4,400 8,400 8,900 8,700 9,100 1-2 days per week past month (26.0) (29.9) (17.3) (27.7) (25.8) (24.7) (29.8) (25.6) 103,800 9,400 9,900 7,900 18,400 22,400 15,600 20,300 3 or more days per week (57.0) (55.4) (60.9) (50.0) (56.4) (62.5) (53.6) (56.9) 76,400 7,400 6,500 8,300 11,700 16,100 11,800 14,600 Watched television more than two hours per day (41.9) (43.3) (40.4) (52.5) (35.9) (44.7) (40.7) (40.9) 33,100 2,900 4,100 2,200 5,800 6,500 5,400 6,200 Used computer more than two hours per day (18.2) (17.2) (25.3) (13.8) (17.8) (17.9) (18.7) (17.6) 93,200 8,800 7,500 7,700 18,400 15,400 16,600 18,700 Did not participate in worksite wellness program (82.0) (83.9) (73.8) (82.1) (88.2) (73.5) (85.1) (84.3) 7,300 1,100 1,100 1,100 200 600 1,100 2,100 Commutes to work more than 60 minutes (7.2) (10.7) (11.7) (12.0) (1.3) (3.3) (6.4) (10.1) 98,000 9,000 9,000 8,000 16,500 18,500 16,700 20,400 Car, truck, or van (86.4) (85.4) (88.1) (85.9) (78.9) (87.9) (86.6) (91.6) 1,000 200 200 300 300 Public transit ------(0.9) (2.3) (1.0) (1.2) (1.5) Method of getting to work 2,900 1,000 100 500 900 300 Bicycle ------(2.5) (9.9) (1.2) (5.1) (4.3) (1.6) 6,500 100 700 400 2,100 1,100 1,100 900 Walking (5.7) (1.2) (7.3) (4.7) (9.9) (5.3) (5.9) (3.9) No neighborhood outdoor space or park they feel 39,400 4,900 4,400 3,300 8,800 7,200 2,600 8,300 comfortable visiting during day (21.8) (29.1) (27.1) (21.2) (26.9) (20.1) (8.9) (23.8) 12,000 3,200 900 800 800 1,300 2,800 2,300 Did not go somewhere during the day due to safety (6.6) (19.1) (5.3) (5.4) (2.5) (3.6) (9.5) (6.3) 58,800 7,200 6,400 5,200 10,200 8,700 6,700 14,500 Low social capital in neighborhood (32.4) (42.2) (39.5) (33.7) (31.2) (24.0) (23.2) (41.2) 96,900 9,700 8,800 9,000 19,100 18,100 13,400 18,900 Not active in a faith community (53.6) (57.0) (55.2) (57.9) (58.4) (50.7) (46.1) (53.8) 108,500 9,300 8,800 12,200 19,200 19,800 14,900 24,200 Did not use public recreation facilities in the Tri-County Area (59.4) (54.8) (54.6) (77.7) (58.5) (54.9) (51.4) (67.6) Has not heard of the Tri-County Area Health & Wellness 134,000 11,000 9,800 11,500 22,900 28,400 25,400 25,000 Foundation (74.2) (65.1) (61.4) (73.3) (70.9) (78.9) (88.2) (71.5) Note: ---- equals insufficient cases for analysis (n<30). Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County Area Household Health Survey
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Table 17. Health Behaviors of Tri-County Area Adults by Area Daniel Owen J. Tri-County Pottstown Pottsgrove Spring-Ford Perkiomen Boyertown Boone Roberts Area Borough Area Area Valley Area Area Area Area N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) 34,400 5,200 3,500 4,100 4,900 5,700 4,700 6,400 Smokes Cigarettes (18.9) (30.7) (21.8) (25.7) (15.1) (15.7) (16.0) (17.9) 20,600 2,000 2,200 2,200 4,800 2,800 2,700 3,800 Someone smokes inside the home (11.3) (12.2) (13.5) (13.9) (14.6) (7.9) (9.4) (10.7) Have tried quitting smoking in past year 20,300 3,200 1,600 2,300 2,900 2,800 4,000 3,600 (among smokers) (59.1) (62.5) (45.7) (56.2) (58.2) (49.5) (85.3) (55.9) Consumed 5 or more drinks in past month on 5,100 600 800 500 600 1,000 200 1,400 five or more occasions (2.8) (3.6) (4.9) (3.1) (1.9) (2.9) (0.7) (4.0) Source: PHMC’s 2012 Southeastern Pennsylvania Household Health Survey and 2013 Tri-County AreaHousehold Health Survey
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Table 18. Health Screenings for Tri-County Area Adults by Area
Pottstown Pottsgrove Daniel Owen J. Spring-Ford Perkiomen Boyertown Tri-County Area Borough Area Boone Area Roberts Area Area Valley Area Area N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) Adults who did NOT receive: Blood pressure test in the past 16,800 2,400 500 1,500 2,500 2,300 2,200 5,400 year 9.3% 14.3% 3.2% 9.6% 7.7% 6.5% 7.6% 15.1% Blood cholesterol test in the past 52,700 4,600 4,900 6,000 11,000 8,300 6,900 11,000 year 30.0% 29.1% 31.0% 39.8% 34.3% 23.1% 25.0% 32.6% Colonoscopy in past year 71,700 5,800 6,500 6,400 14,700 12,600 10,800 14,900 (adults 50+) 83.1% 80.5% 88.0% 88.1% 87.6% 75.4% 89.9% 78.6% Pap smear in the past year 41,400 3,300 3,500 3,500 6,200 7,400 7,500 10,100 (women) 45.3% 40.1% 46.3% 44.4% 37.1% 44.8% 45.2% 55.4% Mammogram in the past year 29,000 3,400 2,500 2,500 3,900 5,900 5,200 6,800 (women 40+) 42.8% 38.6% 41.9% 52.3% 27.7% 50.2% 41.9% 52.3% PSA or rectal exam for prostate 15,400 1,800 600 2,200 2,700 3,200 2,100 2,900 cancer in past year (men 45+) 36.4% 55.0% 23.9% 52.9% 34.0% 29.7% 37.9% 35.0% Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County AreaHousehold Health Survey
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Table 19. Health Status of Tri-County Area and Adjacent Area Adults Tri-County Area Berks County Chester County Montgomery County N N N N % % % % 153,100 266,700 348,000 556,100 Excellent/Very Good/Good 86.0% 84.1% 90.4% 89.2% Health Status 24,800 50,400 36,900 67,500 Fair/Poor 14.0% 15.9% 9.6% 10.8% 29,400 46,200 52,000 86,500 Diagnosed with mental health condition 16.5% 14.6% 13.5% 13.8% Sought professional help for a mental or emotional 16,600 N/A N/A N/A problem 9.4% 18,200 28,400 28,500 59,500 Mental Health Receiving treatment for mental health condition 62.1% 61.5% 55.0% 69.6% 41,200 108,600 High level of stress N/A N/A 23.4% 34.5% 13,100 16,000 35,400 Currently in recovery N/A 7.4% 4.2% 5.7% 60,600 110,600 142,800 228,400 Overweight 34.3% 35.9% 38.0% 37.2% Body Mass Index 53,200 93,100 79,300 181,000 Obese 30.2% 30.2% 21.1% 23.5% 13,700 28,300 36,900 52,200 Cancer 7.7% 8.9% 9.6% 8.3% 28,300 49,200 48,900 87,200 Asthma 15.9% 15.5% 12.7% 14.0% 19,400 44,000 31,600 63,500 Diabetes 10.9% 13.9% 8.2% 10.2% Chronic Health 52,400 105,400 92,200 167,000 High blood pressure Conditions 29.4% 33.4% 24.0% 26.8% 42,100 88,800 153,600 Arthritis N/A 23.7% 23.1% 24.6% 17,300 Heart disease N/A N/A N/A 9.7% 41,600 104,400 130,600 Pain lasting six months or more N/A 23.4% 19.1% 20.9% Notes: N/A equals not asked. Overweight is defined as having a BMI of 25-29 and obese is defined as having a BMI of 30 or greater. High level of stress is defined as seven or higher on a 10 point scale. Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County Area Household Health Survey
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Table 20. Selected Health Status and Access to Care Indicators of Tri-County Area and Adjacent County Children
Tri-County Area Chester County Montgomery County
N N N (%) (%) (%) 54,300 118,400 180,900 Excellent/Very Good/Good 97.7% 95.7% 99.1% Health Status 1,300 5,400 1,600 Fair/Poor 2.3% 4.3% 0.9% 6,900 12,800 15,300 Overweight 18.9% 16.5% 13.4% Body Mass Index 5,700 10,400 20,900 Obese 15.6% 13.3% 18.3% 7,400 16,500 23,400 Ever diagnosed with asthma 13.6% 13.3% 12.8% 1,700 3,300 3,700 No regular source of care 3.1% 2.7% 2.1% 1,900 4,900 7,200 Family or friends 3.6% 4.0% 3.9% Source of information on Physician or other health care 47,300 112,300 166,200 children’s health professional 88.9% 90.7% 90.9% 4,000 4,300 7,500 Internet 7.5% 3.5% 4.1% 9,800 23,200 36,600 Did not visit dentist in the past year 17.9% 18.7% 20.0% Note: These questions were not asked in the Berks County Household Health Survey. Source: PHMC’s 2012 Southeastern Pennsylvania and 2013 Tri-County Area Household Health Survey
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Table 21. Health Insurance and Source of Care of Tri-County Areaand Adjacent County Adults Montgomery Tri-County Area Berks County Chester County County
N N N N % % % % 11,300 33,000 26,100 38,900 Uninsured (18-64) 7.8% 13.3% 8.9% 8.1% 24,800 30,200 63,900 89,900 No prescription drug coverage 14.1% 10.8% 16.7% 14.5% 17,500 37,500 41,000 64,000 No regular source of care 9.8% 11.8% 10.6% 10.3% Note: N/A equals not asked Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County Area Household Health Survey
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Table 22. Cost Barriers to Care for Tri-County Area and Adjacent County Adults Montgomery Tri-County Area Berks County Chester County County N N N N In the past year DID NOT… % % % % 25,300 37,900 37,900 63,300 Seek health care due to cost 14.2% 12.0% 9.8% 9.7% 6,800 19,200 Seek health care due to transportation problems N/A N/A 3.8% 6.1% 27,200 43,400 43,900 70,400 Fill prescription due to cost 15.3% 13.7% 11.4% 11.3% Last year 74,100 140,000 229,700 Difficult or very difficult to pay housing costs N/A 42.6% 37.6% 37.9% Note: N/A equals not asked Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County Area Household Health Survey
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Table 23. Nutrition of Tri-County Areaand Adjacent County Adults Montgomery Tri-County Area Berks County Chester County County
N N N N % % % % 122,300 221,100 264,700 433,700 Number of fruits and 0-3 servings 69.8% 71.9% 69.4% 70.6% vegetables consumed in 52,900 86,200 116,600 181,000 typical day 4 or more servings 30.2% 28.1% 30.6% 29.4%
Difficult or very difficult to find fruits or vegetables 8,800 10,500 11,000 9,500 in their neighborhood 4.9% 3.3% 2.9% 1.6%
Overall quality of groceries in neighborhood stores 17,200 35,100 32,100 39,800 is fair or poor 9.8% 11.2% 8.4% 6.4% 19,500 45,500 26,200 49,000 Cut meal size or skip a meal due to cost 11.0% 14.4% 6.8% 7.8% 98,000 164,600 229,900 371,900 How many times eaten at None 55.1% 51.9% 59.9% 59.5% fast food restaurant in 79,900 152,600 154,600 252,700 past week 1 or more times 44.9% 48.1% 40.2% 40.5% Note: N/A equals not asked Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County Area Household Health Survey
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Table 24. Physical Activity of Tri-County Area and Adjacent County Adults Montgomery Tri-County Area Berks County Chester County County
N N N N (%) (%) (%) (%) 30,600 49,000 34,600 56,000 None 17.2% 15.6% 9.0% 9.0% Number of times 45,200 92,400 131,300 199,400 1-2 days per week exercised in past month 25.5% 29.4% 34.1% 32.0% 3 or more days per 101,800 172,800 218,700 368,600 week 57.3% 55.0% 56.9% 59.1% 76,400 147,700 257,400 Watched television more than two hours per day N/A 41.9% 38.5% 41.2% 33,100 77,100 125,000 Used computer more than two hours per day N/A 18.2% 20.0% 20.1% No neighborhood outdoor space or park they feel 39,400 74,500 71,900 100,900 comfortable visiting during day 21.8% 23.9% 19.1% 16.3% 11,600 26,000 14,300 31,600 Did not go somewhere during the day due to safety 6.5% 8.3% 3.7% 5.1% 58,800 85,500 96,200 149,500 Low social capital in neighborhood 32.4% 31.0% 25.3% 24.1% Note: N/A equals not asked Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County Area Household Health Survey
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Table 25. Nutrition and Physical Activity of Tri-County Area and Adjacent County Children
Tri-County Area Chester County Montgomery County
N N N % % % 31,300 68,400 98,900 Number of fruits and 0-3 68.0% 67.7% 64.7% vegetables consumed in 14,700 32,600 53,900 typical day 4+ 32.0% 32.3% 35.3% 14,400 26,100 43,100 Watched television more than two hours per day (31.3) (23.4) (26.3) 8,200 15,800 22,900 Used computer more than two hours per day (17.8) (14.2) (14.0) Less than one hour per week in early childhood 8,000 15,200 23,700 education setting (50.0) (41.3) (42.1) Note: N/A equals not asked Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County Area Household Health Survey
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Table 26. Health Behaviors of Tri-County Areaand Adjacent County Adults Montgomery Tri-County Area Berks County Chester County County
N N N N % % % % 34,300 64,500 51,100 83,000 Smokes Cigarettes 19.3% 20.4% 13.3% 13.3% Have tried quitting smoking in past year (among 20,400 34,900 28,700 44,400 smokers) 59.2% 54.3% 56.2% 54.6% 20,500 43,900 30,100 53,000 Someone smokes inside the home 11.5% 13.8% 7.8% 8.5% Consumed five or more drinks in past month on five 5,100 18,100 14,100 20,000 or more occasions 2.9% 5.8% 3.8% 3.2% Note: N/A equals not asked Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County Area Household Health Survey
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Table 27. Health Screenings for Tri-County Area Adults and Adjacent Counties Montgomery Tri-County Area Berks County Chester County County N N N N % % % % Adults who did NOT receive: 16,800 41,400 34,500 66,200 Blood pressure test in the past year 9.3% 13.2% 9.0% 10.7% Pap smear in the past year 41,400 66,300 82,600 138,300 (women) 45.3% 41.0% 42.0% 41.5% Mammogram in the past year 29,000 44,800 53,800 82,500 (women 40+) 42.8% 40.6% 40.3% 34.8% Colonoscopy/Sigmoidoscopy in the past 71,700 132,800 163,800 274,300 year (adults 50+) 83.1% 86.5% 84.3% 83.7% Colonoscopy/Sigmoidoscopy in the past 27,200 46,900 55,600 86,200 10 years (adults 50+) 31.5% 30.6% 28.6% 26.3% PSA or rectal exam for prostate cancer in 15,000 43,200 44,600 73,100 past year (men 45+) 36.4% 47.4% 42.3% 44.3% Source: PHMC’s 2012 Southeastern Pennsylvania and Berks County Household Health Surveys, and 2013 Tri-County AreaHousehold Health Survey
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Table 28. Health Status of Tri-County Area Adults by Sub-Area, 2008 Owen J. Tri-County Pottstown Pottsgrove Daniel Spring-Ford Perkiomen Boyertown Roberts Area Borough Area Boone Area Area Valley Area Area Area
2008 2008 2008 2008 2008 2008 2008 2008 N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) 138,439 12,383 12,410 12,986 21,484 29,311 22,887 26,978 Excellent/Very Good/Good Health 84.1% 78.8% 79.2% 87.1% 85.8% 91.0% 84.3% 79.4% Status 26,250 3,323 3,256 1,925 3,560 2,903 4,270 7,013 Fair/Poor 15.9% 21.2% 20.8% 12.9% 14.2% 9.0% 15.7% 20.6% 62,225 6,137 5,738 6,046 10,263 11,192 10,775 12,074 Overweight Body Mass 38.5% 39.5% 37.7% 42.2% 42.3% 35.1% 39.8% 36.3% Index 39,774 3,952 5,190 3,473 3,568 7,634 7,461 8,496 Obese 24.6% 25.4% 34.1% 24.2% 14.7% 23.9% 27.6% 25.5% 19,113 2,338 4,113 1,453 2,528 3,764 2,188 2,729 Asthma 11.6% 14.9% 26.3% 9.7% 10.1% 11.7% 8.1% 8.0% Chronic 14,244 2,208 1,336 1,075 1,377 3,008 1,605 3,635 Health Diabetes 8.7% 14.1% 8.5% 7.3% 5.5% 9.3% 6.1% 10.7% Conditions 43,083 5,118 3,042 2,523 7,504 9,141 7,302 8,453 High blood pressure 26.1% 32.6% 19.4% 16.9% 30.0% 28.3% 26.9% 24.8% Source: PHMC’s 2008 Pottstown Borough Household Health Survey (n=596)
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Table 29. Health Insurance and Source of Care of Tri-County Area Adults by Sub-Area, 2008 Daniel Owen J. Pottstown Pottsgrove Spring-Ford Perkiomen Boyertown Tri-County Area Boone Roberts Borough Area Area Valley Area Area Area Area N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) Uninsured (18- 5,843 1,919 630 214 965 762 ___ 1,353 64) 4.3% 14.6% 4.9% 1.6% 4.6% 2.8% 5.0% No regular 14,180 2,019 1,955 1,520 1,737 3,182 2,269 1,498 source of care 8.6% 12.9% 12.8% 10.2% 6.9% 9.8% 8.4% 4.4% Did not visit 38,969 4,861 5,245 4,652 6,280 5,622 3,932 8,377 dentist in past 23.6% 30.9% 33.8% 31.2% 25.1% 17.4% 14.3% 24.6% year Source: PHMC’s 2008 Pottstown Borough Household Health Survey (n=596) ___ indicates insufficient cases for analysis
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Table 30. Health Behaviors of Tri-County Area Adults by Sub-Area. 2008 Owen J. Tri-County Pottstown Pottsgrove Daniel Spring- Perkiomen Boyertown Roberts Area Borough Area Boone Area Ford Area Valley Area Area Area N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) Number of 8,377 10,631 11,745 10,392 16,583 24,418 17,277 17,277 0-3 fruits and 24.6% 71.2% 76.4% 72.3% 67.0% 77.2% 63.8% 63.8% vegetables 49,469 4,303 3,629 3,982 8,162 7,201 9,816 12,376 consumed in 4+ 30.8% 28.8% 23.6% 27.7% 33.0% 22.8% 36.2% 38.2% typical day Number of 30,996 2,501 3,517 3,505 5,795 4,597 4,816 6,265 None times 17.0% 14.7% 21.8% 22.3% 17.8% 12.8% 16.6% 17.5% physically 1-2 days per 47,308 5,096 2,798 4,359 8,415 8,855 8,654 9,131 active in past week 26.0% 29.9% 17.3% 27.7% 25.8% 24.7% 29.8% 25.6% week for 30 3 or more 103,833 9,428 9,849 7,861 18,381 22,396 15,587 20,331 minutes or days per 57.0% 55.4% 60.9% 50.0% 56.4% 62.5% 53.6% 56.9% more week 34,380 5,192 3,487 4,051 4,935 5,662 4,654 6,399 Smokes cigarettes 18.9% 30.7% 21.8% 25.7% 15.1% 15.7% 16.0% 17.9% 58,847 7,171 6,381 5,246 10,177 8,662 6,724 14,486 Low social capital 32.4% 42.2% 39.5% 33.7% 31.2% 24.0% 23.2% 41.2% Source: PHMC’s 2008 Pottstown Borough Household Health Survey
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Table 31. Health Screenings for Pottstown Borough Adults by School District, 2008 Daniel Tri-County Pottstown Pottsgrove Owen J. Spring- Perkiomen Boyertown Boone Area Borough Area Roberts Area Ford Area Valley Area Area Area N N N N N N N N (%) (%) (%) (%) (%) (%) (%) (%) Adults who did NOT receive: Blood pressure test in 16,808 2,406 496 1,519 2,496 2,324 2,163 5,404 the past year 9.3% 14.3% 3.2% 9.6% 7.7% 6.5% 7.6% 15.1% Pap smear in the past 41,435 3,274 3,525 3,485 6,187 7,380 7,506 10,078 year 45.3% 40.1% 46.3% 44.4% 37.1% 44.8% 45.2% 55.4% (women) Mammogram in the 28,998 2,159 2,494 2,539 3,916 5,921 5,234 6,735 past year 42.8% 38.6% 41.9% 52.3% 27.7% 50.2% 41.9% 52.3% (women 40+)
Source: PHMC’s 2008 Pottstown BoroughHousehold Health Survey (n=596)
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APPENDIX E: RESOURCE MAPS AND LIST
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Tri-County Area Map
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HEATLH ASSETS TRI-COUNTY AREA RESOURCES AND ASSETS Name Address City State Zip Community Health Centers Community Health & Dental Care Inc. 11 Robinson St Pottstown PA 19464 The Clinic 143 Church Street Phoenixville PA 19460 Community Dental Services Community Health & Dental Care Inc. 11 Robinson St Pottstown PA 19464 Community Medical and Dental Center Rahns 309 Gravel Pike Rahns PA 19426 Hospitals Phoenixville Hospital 140 Nutt Road Phoenixville PA 19460 Pottstown Memorial Med Center 1600 East High Street Pottstown PA 19464 Behavioral Health Services Chester Counseling Center 701 South Main St Phoenixville PA 19460 Community Services of Devereux 1041 West Bridge Street Phoenixville PA 19460 Creative Health Services 11 Robinson Street Pottsville PA 19464 Fellowship Health Resources 723 Wheatland Street Phoenixville PA 19460 Holcomb Behavioral Health Systems 224 Hall Street Phoenixville PA 19460 Pennsylvania Forensic Associates 871 N Hanover St Pottstown PA 19464 Rehab After Work - Outpatient Treatment 2500 East High St, Building 800 Pottstown PA 19464 Centers Resources For Human Development 100 Porter Rd Pottstown PA 19464 Spring-Ford Drug and Alcohol Counseling S 201 N. Fourth Avenue Royersford PA 19468 Planned Parenthood Planned Parenthood Collegeville Health Center 78 Second Avenue Collegeville PA 19426 Planned Parenthood Pottstown 644 E. High Street Pottstown PA 19464 Urgent Care Services Premier Immediate Medical Care 1139 West Ben Franklin Highway Douglassville PA 19518 Premier Urgent Care (Immediate Medical Care) 43 West Ridge Pike Limerick PA 19468 Premier Immediate Medical Care 35 West Ridge Pike Royersford PA 19468
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Genesis Pregnancy Care Center 888 High Street Pottstown PA 19464 A Baby's Breath 78 2nd Street Collegeville PA 19426 Birthright 327 King Street Pottstown PA 19464
COMMUNITY GARDENS Pottstown community garden 423 Chestnut St Pottstown PA 19464 Pottstown community garden 615 Chestnut St Pottstown PA 19464
FOOD ASSETS
Name Address City State Zip Chain Grocery Stores Acme Markets 785 Starr Street Phoenixville PA 19460 Acme Markets 400 Simpson Drive Chester Springs PA 19425 Acme Markets 31 W Ridge Pike Royersford PA 19468 ALDI 297 Armand Hammer Blvd. Pottstown PA 19464 Costco 14 W Lightcap Rd, Pottstown PA 19464 Genuardi's 70 Buckwalter Rd Ste 211 Royersford PA 19468 Giant Food 86 Glocker Way Pottstown PA 19465 Giant Food 180 Upland SqDr Pottstown PA 19464 Redner's Market 116 County Line Road Boyertown PA 19512 Redner's Market 447 Uwchlan Avenue Chester Springs PA 19425 Redner's Market 201 Second Avenue Collegeville PA 19426 Redner's Market 11 Douglassville Shopping Center Douglassville PA 19518 Redner's Market 202 Schuylkill Road Phoenixville PA 19460 Redner's Market 1300 North Charlotte Street Pottstown PA 19464 Super Fresh 1500 E High St Pottstown PA 19464 Thriftway 2190 E High St Pottstown PA 19464 Walmart 233 Shoemaker Rd Pottstown PA 19464
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Walmart Supercenter 567 Route 100 N Bechtelsville PA 19505 Wegmans 600 Commerce Drive Collegeville PA 19426 Weis Markets 223 Shoemaker Rd Ste 105A Pottstown PA 19464 Weis Markets 1050 E Philadelphia Ave Gilbertsville PA 19525 Whole Foods Market 1139 Ben Franklin Hwy W, Douglassville PA 19518 Farmers Market/Produce Stands Anselma Farmers & Artisans Market 1730 Conestoga Rd. Chester Springs PA 19425 Bauder Farms 1151 Collegeville Rd Collegeville PA 19426 Clover Mill Farm 1439 Clover Mill Road Chester Springs PA 19425 Collegeville Farmers Market 460 East Main Street Collegeville PA 19426 Cooper Creek Farm Market 1856 Farmington Avenue Pottstown PA 19464 Daniel's Produce and Dairy 219 East High Street Pottstown PA 19464 Elverson Farmers Market 83 West Main Street Elverson PA 19520 Greener Partners 3215 Stump Hall Rd Collegeville PA 19426 Happy Ewe Sheep And Wool Farm 2431 Hoffmansville Road Frederick PA 19435 Hickory Run Produce 2145 Big Road Gilbertsville PA 19525 Hopewell Furnace Farm Market 2 Mark Bird Lane Elverson PA 19520 King Produce & Dairy 219 East High St Pottstown PA 19464 Kolb's Farm Store 151 Kolb Road Spring City PA 19475 Longview Center for Agriculture 3215 Stump Hall Rd Collegeville PA 19426 Ludwigs Corner Hardware 1230 Pottstown Pike Glenmoore PA 19343 Milky Way Farm 521 Uwchlan Avenue Chester Springs PA 19425 Phoenixville Farmers Market Corner Of Bridge & Taylor Alley Phoenixville PA 19460 Pottstown Farmers Market 300 High Street Pottstown PA 19464 Ringing Hill Orchards 1453 Bliem Road Pottstown PA 19464 Sulomans Milk Store 2782 Leidy Road Gilbertsville PA 19525 The Farmer's Daughter Farm Market 3190 Schuylkill Road Spring City PA 19475 Varner Farms 746 South Trappe Road Collegeville PA 19426 Vollmecke Orchards FS 155 Cedar Knoll Road Coatesville PA 19520
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Willow Creek Orchards 3215 Stump Hall Road Collegeville PA 19426 Yeagers Farm & Market Inc. 1015 Pike Springs Road Phoenixville PA 19460 Zern's Farmers Market FS 1100 East Philadelphia Avenue Gilbertsville PA 19525 Food Pantries Baptist Church of Phoenixville 248 Church St Phoenixville PA 19460 Bethel A.M.E. Church 401 Beech Street Pottstown PA 19464 Boyertown Salvation Army 409 S. Reading Avenue Boyertown PA 19512 Bright Hope 468 W. King St Stowe PA 19464 Cluster Outreach Center 137 Walnut Street Pottstown PA 19464 Jerusalem Lutheran Church 311 Second Street Schwenksville PA 19473 North Coventry Food Pantry 845 S Hanover Street Pottstown PA 19464 Phoenixville Area Community Services 257 Church St Phoenixville PA 19460 Phoenixville Area Community Services (PACS) . Phoenixville PA 19460 Pottstown Bible Church 431 High Street Pottstown PA 19464 Pottstown Cluster of Religious Communities 57 North Franklin Street Pottstown PA 19464 Pottstown Salvation Army Cupboard 137 King Street Pottstown PA 19464 Project Outreach Food Pantry 145 Chestnut St Spring City PA 19475 Salvation Army Service Unit 570 Fairview Rd Glenmoore PA 19343 St. PeterÆs Episcopal Church 121 Church St Phoenixville PA 19460 The Open Door 350 Main Street Royersford PA 19468
PARKS PARK NAME STREET CITY STATE ZIP
Township, Municipal, and Other Parks Bickel Run Park Kemp Road Pottstown PA 19465 Alfred B Miles Park 545 Sunnybrook Rd Sanatoga
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Amity Community Park 2004 Weavertown Rd Douglassville PA 19518 Amity Park Road Recreation Area 55 Amity Park Road Douglassville PA 19518 Anderson Farm Park 499 Hopwood Rd Collegeville PA 19426 Barto Community Park 120 Barto Road Barto PA 19504 Bechtelsville Community Park S. Main Street Bechtelsville PA 19505 Black Rock Sanctuary 953 Black Rock Rd. Phoenixville PA 19460
Boyertown Community Park 419 South Madison Street Boyertown PA 19512 Brookside Park Virginia St & Brookside Ave Pottstown PA 19464
Brown Street Park 50 Brown St Spring City PA 19475
Cedarville Trail S Hanover Street & E Cedarville Rd Pottstown PA 19465 Central Perkiomen Valley Park 1 Plank Rd Schwenksville PA 19473 Cherry Street Park 108 Micklitz Drive Pottstown PA 19464
Chestnut Street Park 5th Ave & Chestnut St Royersford PA 19468 Church Road Park Rt. 73 & Church Road Skippack PA 19474 Coble Park Rt. 29 & Little Rd Schwenksville PA 19492 Collegeville Community Park Park and Third Avenues Collegeville PA 19426 Community Park on the Ridge 262 Ridge Road Spring City PA 19475
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PUBLIC HEALTH management corporation
Connie Batdorf Park 2350 Pottstown Pike Pottstown Pa 19465
Coventry Woods 2145 Coventryville Rd Pottstown PA 19465 Crimson Lane Open Space 910 Crimson Lane Pottstown 19464
David Meyers Park Rt. 29 Collegeville PA 19426 Deep Creek Nature Park Deep Creek Rd & Pleasant Run Rd Perkiomenville PA 18074
Douglass Park 1320 East Philadelphia Avenue Gilbertsville PA 19525
Douglass Township Municipal Park 1068 Douglass Drive Boyertown PA 19512 Earl Township Park Mountain Rd Earl PA 19512 Ellis Woods Park 855 Ellis Woods Rd Pottstown PA 19465
Forgedale Park Forgedale Rd Barto PA 19504 Fountain of Youth Spray Park 255 Manatawny St Pottstown PA 19464
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PUBLIC HEALTH management corporation
Franklin St Mini-Park Franklin and 5th Streets Boyertown PA 19512
Frederick Friendship Park 3205 Big Road Obelisk PA 19492 Ganshahawny Park 343 Old Philadelphia Pike Boyertown PA 19512 Gerald D. Richards Park 2130 Buchert Rd Sanatoga PA 19464
Goose Run Park 1600 Levengood Road Boyertown PA 19512 Hall Street Park 6 S. Church Street Spring City PA 19475
Hanover Meadows Park S Hanover Street & Pottstown Pike Pottstown PA 19465
Heather Place Park 1420 Heather Place Pottstown PA 19465
Hickory Park 2140 Big Rd Gilbertsville PA 19525
Hill Road Recreation Area 133 Hill Road Douglassville PA 19518
Hollenboch Park Howard Street Playground Howard St & School Lane Stowe PA 19464 Hunsberger Woods E Ninth Avenue Collegeville PA 19426 Ironstone Park 141 Grist Mill Road Boyertown PA 19512
Jeanne Rosset French Memorial Park Township Line Rd & Collegeville Rd
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Keim Street Open Space Keim and Mulberry Streets Pottstown 19464
Kenilworth Park Brown St & Keller Rd Kenilworth Pa 19465 Kimberton Community Park and Fairgrounds 2202 Kimberton Rd Phoenixville PA 19460
Kulp Field & Hoffman Field Gilbertsville Road & West Moyer Road Pottstown PA 19464
Lake Drive Park 520 Lake Drive Douglassville PA 19518
Layfield Park Dotterer Road Perkiomenville PA 18064
Liberty Hill Open Space 2525 Allison Drive Sanatoga PA 19464
Limerick Community Park &Manderach Swamp Pike & Ziegler Road Limerick PA 19468 Memorial Playground Lincoln Park Orange & High Sts Birdsboro PA 19508 Linfield Sports Park Longview Road Linfield PA 19468
Livingood Park S. Chestnut St. Elverson PA 19520 Locust Grove Recreation Area 43 3rd St Douglassville PA 19518
Main Bird Park Main & Water Sts Birdsboro PA 19508 Main Street Park W Main Street Trappe PA 19426 Manatawny Park Manatawny St & Sell Rd Stowe PA 19464 Maple Street Park 1431 Maple St Pottstown PA 19464
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PUBLIC HEALTH management corporation
Meadow Park 300 Main St Schwenksville PA 19473
Memorial/Manatawny Park 255 Manatawny St Pottstown PA 19464 Mocharniuk Meadows Monocacy Hill Recreation Area Geiger Road Douglassville PA 19518
Municipal Park Franklin and 3rd Streets Boyertown PA 19512
Myron S. Wheeler Recreation Area/Township 2004 Weavertown Road Douglassville PA 19518 Field
New Chestnut Street Park Chestnut & N. Washington Sts Pottstown PA New Chestnut Street Park N Washington St & Chestnut St Pottstown PA 19464 New Hanover Community Park 2766 Gail Drive Gilbertsville PA 19525 Norton Park Old Chestnut Street Park 417 Washington St Pottstown PA 19464 Old Timer's Field 900 Grosstown Rd Stowe PA 19464 Olivet Boys' and Girls' Club at the Richard J. 640 BeechSt Pottstown PA 19464 Ricketts Center Optimist Club & Middle Creek Fields 3065 N Charlotte St Gilbertsville PA 19525 Palmer Park Heckler & Creamery Rds Skippack PA 19474 Penn Street Courts Pickering Grove Park Pike Springs Rd Chester Springs PA 19425 Pine Creek Park 1488 Yellow Springs Rd Chester Springs PA 19425 Pineland Park 401 Pineland Rd Birdsboro PA 19508 Pleasant Run Park 600 Schultz Road Perkiomenville PA 18074
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PUBLIC HEALTH management corporation
Pleasantview Park 1903 Bleim Rd Sanatoga PA 19464 Pollock Park South & Cross Sts Pottstown PA 19464 Potts Drive Park Potts Dr& W Beech St Pottstown PA 19464 Pruss Hill Barn and Open Space 2595 Pruss Hill Road Sanatoga 19464 Rambo Park W Fifth Avenue Trappe PA 19426 Reeves Park 2nd Ave Phoenixville PA 19460 Ringing Rocks Lower Nature Park 1800 N Keim Street Pottstown PA 19464 Ringing Rocks Upper Park 815 White Pine Lane Pottstown PA 19464 River Road Recreation Area Riverbend Park & Anderson Field River Rd Pottstown PA 19465 Riverfront Park 140 College Dr Pottstown PA 19464 Riverside Park Riverside Park, Location 1 E Schuylkill Ave & Penn St Pottstown PA 19465 Riverside Park, Location 2 River Rd & S York St Pottstown PA 19465 Rustic Park 1314 Hay Creek Rd Birdsboro PA 19508 Sanatoga Park 223 S. Sanatoga Road Sanatoga PA 19464 Schuylkill River Park 2116 Sanatoga Station Rd Sanatoga PA 19464 Schuylkill River Trail Pottstown PA 19464 Shaner's Grove 1900 N. Keim Street Pottstown pa 19464 Smith Family Plaza 100 E High St Pottstown PA 19464 Snell Park & Norton Park 1302 Snell Rd Sanatoga PA 19464 South Street Park South St & Washington St Pottstown PA 19464 Spring City Boat Ramp Spring City Schuylkill River Trail 10 E. Bridge Street Spring City PA 19475 Sprogel's Run Park 53-54 Doe Lane Sanatoga 19464 Spruce Street Park Spruce St & Gay Street Pottstown PA 19464 Swamp Creek Park Terrace Lane Park Mineral St & Terrace La Pottstown PA 19464 Towpath Park Route 724 Pottstown PA 19465 Trappe Borough Hall Park 525 W Main Street Trappe PA 19426
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PUBLIC HEALTH management corporation
Trilogy Park 75 W King St Pottstown PA 19464 Trinley River Park Railroad Street &Trinley Road Linfield PA 19468 Turnberry Farms Union Twp Recreation Area 991 E Main St Birdsboro PA 19508 Upper Providence Township Recreation Center 499 Hopwood Rd Collegeville PA 19426 Upper Schuylkill Valley Park 1600 Black Rock Rd Royersford PA 19468 Vest Pocket Park W. First St Birdsboro PA 19508 Veterans Park 646 West Ridge Pike Limerick PA 19468 Victory Park 2nd Ave & Green St Royersford pa 19468 Vine Street Playground Vine & Quinter Streets Stowe PA 19464 Walnut Street Park 600 Walnut St Pottstown PA 19464 Warwick County Park 382 County Park Rd Pottstown PA 19465 Washington Street Park N Washington St & West St Pottstown PA 19464 Washington Township Park Victoria Dr& Niantic Rd Barto PA 19504 Water Works Park W First Avenue Trappe PA 19426 Waterworks Park Waterworks Park Collegeville PA 19426 Welkinweir 1368 Prizer Road Pottstown Pa 19465 West Vincent Township Park Conestoga & St. Matthew's Rd Chester Springs PA 19425 West Vincent Township Park Conestoga Road and St. Matthews Road Chester Springs PA 19425
Woody's Woods 3131 Coventryville Road Pottstown PA 19465
Outdoor Municipal Pools Beulah Land Park 2675 E High St Pottstown PA 19464
North End Swimming Club 901 North Adams Street Pottstown PA 19464
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State Parks French Creek State Park 843 Park Rd Elverson PA 19520 Marsh Creek State Park Chester Springs PA 19425
Evansburg State Park 851 May Hall Rd Collegeville PA 19426
National Historic Site Hopewell Furnace 2 Mark Bird Ln Elverson PA 19520 Dog Parks Bark Park 75 W King St Pottstown PA 19464 Memorial Park 255 Manatawny St Pottstown PA 19464
School Outdoor Tracks Boyertown Jr High School West 380 S Madison St Boyertown PA 19512
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PUBLIC HEALTH management corporation
Boyertown East Junior High School 2020 Big Road Gilbertsville PA 19525
Boyertown Area Senior High School 120 North Monroe Street Boyertown PA 19512
Daniel Boone High School 501 Chestnut St Birdsboro PA 19508
Owen J Roberts Middle School 881 Ridge Rd Pottstown PA 19465
Owen J Roberts High School 981 Ridge Rd Pottstown PA 19465
Perkiomen Valley Middle School 100 Kagey Rd Collegeville PA 19426
Perkiomen Valley Middle School West 220 Big Rd Zieglersville PA 19492
Perkiomen Valley High School 509 Gravel Pike, Collegeville PA 19426
Pottsgrove Middle School 1351 N Hanover St Pottstown PA 19464
Pottsgrove Senior High School 1345 Kauffman Rd Pottstown PA 19464
Pottstown Middle School 600 N Franklin St Pottstown PA 19464
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Pottstown Senior High School 750 N Washington St Pottstown PA 19464
Spring-Ford Middle School 700 Washington St Royersford PA 19468
Spring-Ford Senior High School 350 S Lewis Rd Royersford PA 19468
SOCIAL SERVICES Name Address City State Zip Senior Centers Berks Encore - Birdsboro 201 East Main Street Birdsboro PA 19508 Phoenixville Senior Adult Activity Center 153 Church St Phoenixville PA 19460 Pottstown Borough Seniors' Center 724 North Adams St Pottstown PA 19464 The Center at Spring Street in Boyertown 200 West Spring Street Boyertown PA 19512 Shelter Services Berks County Housing Authority 256 Haycreek Rd Birdsboro PA 19508 Good Samaritan Shelter 141 High Street Phoenixville PA 19460 St. Mary's Franciscan Shelter 209 Emmett Street Phoenixville PA 19460 The Ministries At MAIN St Main St Pottstown PA 19465 YMCA/YWCA Boyertown Area YMCA 301 W Spring St Boyertown PA 19512 Freedom Valley YMCA 19 W. Linfield-Trappe Road Limerick PA 19468 Gilbertsville Center YMCA 144 Holly Rd Gilbertsville PA 19525 Phoenixville Branch YMCA 400 E Pothouse Rd Phoenixville PA 19460
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Pottstown YMCA 724 N Adams St Pottstown PA 19464 Spring Valley Branch YMCA 19 W. Linfield-Trappe Road Limerick PA 19468 William S. Hollenbach Center 3065 N Charlotte St Gilbertsville PA 19525 YWCA Tri-County 315 King St Pottstown PA 19464 WIC Offices Boyertown Center 200 West Spring Street Boyertown PA 19512 Pottstown WIC Clinic 262 King St Pottstown PA 19464 WIC Satellite Clinic - Spring City 145 Chestnut Street Spring City PA 19475 Additional Social Services 1304 E. High St. Pottstown PA 19464 Berks and Beyond Employment Services, Inc.
Phoenixville Area Community Services 257 Church St Phoenixville PA 19460 Pottstown Family Center 1976 East High Street Pottstown PA 19464 Salvation Army 137 King St Pottstown PA 19464
SCHOOLS
High Schools Boyertown Area Senior High School 120 North Monroe St Boyertown PA 19512 Daniel Boone Area High School 501 Chestnut St Birdsboro PA 19508 Owen J. Roberts High School 981 Ridge Rd Pottstown PA 19465 Perkiomen Valley High School 509 Gravel Pike Collegeville PA 19426 Pottsgrove High School 1345 Kauffman Rd Pottstown PA 19464 Pottstown High School 750 N. Washington Street Pottstown PA 19464 Spring-Ford Area High School 10-12 Grade 350 S Lewis Rd Royersford PA 19468 Center Spring-Ford Area High School 9th Grade Center 400 S Lewis Rd Royersford PA 19468 Western Montgomery Career and Technology 77 Graterford Road Limerick PA 19468 Center
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Middle Schools Boyertown Area Junior High School-East 2020 Big Rd Gilbertsville PA 19525 Boyertown Area Junior High School-West 380 South Madison St Boyertown PA 19512 Daniel Boone Middle School 1845 Weavertown Rd Douglassville PA 19518 Owen J. Roberts Middle School 881 Ridge Rd Pottstown PA 19465 Perkiomen Valley Middle School East 100 Kagey Road Collegeville PA 19426 Perkiomen Valley Middle School West 220 Big Road Zieglerville PA 19492 Pottsgrove Middle School 1351 N Hanover Rd Pottstown PA 19464 Pottstown Middle School 600 North Franklin Street Pottstown PA 19464 Spring-Ford Area 7th Grade Center 833 S Lewis Rd Royersford PA 19468 Spring-Ford Area 8th Grade Center 700 Washington St Royersford PA 19468 Spring-Ford Area Intermediate School 5th-6th 833 S Lewis Rd Royersford PA 19468 Grade Center
Elementary Schools Amity Elementary Center 200 Boone Dr Douglassville PA 19512 Birdsboro Elementary Center 400 W Second St Birdsboro PA 19512 Boyertown Elementary School 641 E Second St Boyertown PA 19512 Brooke Elementary School 339 N Lewis Rd Royersford PA 19525 Colebrookdale Elementary School 1001 Montgomery Ave Boyertown PA 19435 Earl Elementary School 22 Schoolhouse Rd Boyertown PA 19512 East Coventry Elementary School 932 Sanatoga Rd Pottstown PA 19504 East Vincent Elementary School 340 Ridge Rd Spring City PA 19464 Edgewood Elementary School 920 Morris Street Pottstown PA 19464 Elizabeth B. Barth Elementary School 467 W Walnut Street Pottstown PA 19464 Evans Elementary School 125 Sunset Rd Limerick PA 19464 Evergreen Elementary School 98 Kagey Road Collegeville PA 19464 Franklin Elementary School 970 N. Franklin Street Pottstown PA 19464 French Creek Elementary 3590 Coventryville Rd Pottstown PA 19464 Gilbertsville Elementary School 36 Congo Rd Gilbertsville PA 19464 Limerick Elementary School 81 Limerick Center Rd Royersford PA 19518
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PUBLIC HEALTH management corporation
Lincoln Elementary School 461 N York Street Pottstown PA 19508 Lower Pottsgrove Elementary School 1329 Buchert Rd Pottstown PA 19508 Monocacy Elementary Center 576 Monocacy Creek Rd Birdsboro PA 19425 New Hanover-Upper Frederick Elementary 2547 Big Rd Frederick PA 19465 School North Coventry Elementary School 475 Kemp Rd Pottstown PA 19465 Oaks Elementary School Oaks School Drive Oaks PA 19475 Pine Forge Elementary School 8 Glendale Rd Boyertown PA 19465 Ringing Rocks Elementary School 1401 Kauffman Rd Pottstown PA 19468 Royersford Elementary School 450 Spring St Royersford PA 19468 Rupert Elementary School 1230 South Street Pottstown PA 19468 Schwenksville Elementary School 55 Second Street Schwenksville PA 19456 Skippack Elementary School 4081 Heckler Road Collegeville PA 19468 South Elementary School 200 East Third Avenue Trappe PA 19475 Spring City Elementary Hybrid Learning School 190 South Wall Street Spring City PA 19468 Upper Providence Elementary School 833 South Lewis Road Royersford PA 19426 Washington Elementary School 1406 Route 100 Barto PA 19426 West Pottsgrove Elementary School 25 Grosstown Rd Stowe PA 19426 West Vincent Elementary School 2570 Conestoga Rd Chester Springs PA 19473
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APPENDIX F: STATISTICAL SIGNIFICANCE TESTING RESULTS
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Statistical Significance of Tri-County Area Health Indicators Compared with the Remainder of Berks, Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties
Adults
Health Indicator Tri-County Area Remainder of SEPA & Significance Berks County
In recovery for alcohol or other drugs 7.5% 8.4%* ns
In fair or poor health 14.4% 16.1% ns
Ever diagnosed with asthma 16.0% 16.0% ns
Ever diagnosed with diabetes 10.9% 12.5% ns
Ever diagnosed with cancer 7.9% 8.8% ns
Ever diagnosed with high blood pressure 29.3% 31.2% ns
Currently has health insurance (ages18-64) 92.3% 87.6% .001
Currently has prescription drug coverage 86.0% 81.9% .001
Has a regular source of healthcare 90.0% 88.7% ns
Did not fill prescription in past year due to 15.9% 14.6% ns cost.
Did not receive care in past year due to cost 14.0% 12.3% ns
Overweight or obese (BMI 25 or higher) 64.9% 62.9% ns
Fewer than 4 servings of fruits and 70.0% 74.0% .01 vegetables per day
Consumed fast food one or more times in 44.8% 42.6% ns past week
Fewer than 3 days with 30 minutes of 42.8% 44.4% ns exercise per week in past month
Currently smokes cigarettes 19.4% 18.4% ns
Tried to quit smoking in past year 58.2% 56.4% ns
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Problem drinking (5+ drinks in 5 days during 3.0% 4.3% .05 past month)
Dental visit in past year 70.8% 68.1% .05
Blood pressure taken in past year 90.6% 89.3% ns
Pap test in past year (female) 54.5% 58.3% .05
Breast exam in past year (female) 65.9% 67.0% ns
Mammogram in past year (female 40+) 56.5% 63.0% .01
Prostate screening in past year (male 45+) 63.1% 54.3 .01
Colonoscopy or sigmoidoscopy in past year 17.3% 18.3% ns (50+)
Low Social Capital 33.0% 25.9% .001
Children
Health Indicator Pottstown Area Remainder of SEPA Significance & Berks County
In fair or poor health 2.4% 4.7%* .05
Has a regular source of healthcare 96.9% 97.1%* ns
Dental visit in past year (ages 4+) 95.3% 90.6%* .01
Overweight or obese (BMI percentile 34.8% 33.4%* ns >= 85)
* Data only available for remainder of SEPA because this question was not asked in the Berks County Household Health Survey.
KEY: ns = not significant, .05 = statistically significant .01 = very statistically significant .001 = very highly statistically significant Green = statistically significantly better than remainder of SEPA+Berks Red = statistically significantly worse than remainder of SEPA+Berks
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